When to do culture in urinary tract infections

A brief review of the value of quantitative bacteriology of the urine in patients with symptoms of urinary tract infections is presented. Changes in our approach to the diagnosis of urinary tract infections are briefly discussed. The economic value of empiric treatment without urine cultures in young women with dysuria and frequency is presented along with our approach to patients with asymptomatic bacteriuria in the presence of an indwelling bladder catheter. In addition, specific groups of patients with symptomatic urinary tract infections who require urine cultures in order to receive optimal antimicrobial therapy is reviewed. Although these suggestions may not be appropriate for all patients in each category, their use in some patients is likely to result in economic benefits without reducing the quality of their health care. (C) 1999 Published by Elsevier Science B.V. All rights reserved.