I wondered if this would be useful to those having repeated URI's. It comes from the NICE site:
Urine for culture
Should I send urine for culture and sensitivity for women with recurrent urinary tract infections?
Send urine for culture and sensitivity from all women with recurrent urinary tract infections.Back to topBasis for recommendation
Sending an MSU for culture in women with recurrent urinary tract infections
This recommendation is based on expert advice from the Health Protection Agency because women with recurrent urinary tract infections are more likely to have a resistant strain [HPA, 2011].
This is information for doctors.
Urine should be sent for culture and sensitivity for ALL women who present with symptoms of a UTI. How can a patient be given the correct treatment if you don't know which antibiotics are recommended?
I would have thought that too Matron, yet this is the guidelines for a UTI that isn't recurrent - it doesn't make sense, does it!:
Send urine for culture from women with a first presentation of a urinary tract infection (UTI) if they have any of the following:
Impaired renal function.
An abnormal urinary tract (for example renal calculus, vesicoureteric reflux, reflux nephropathy, neurogenic bladder, urinary obstruction, or recent instrumentation).
Immunosuppression (for example because they have poorly controlled diabetes mellitus or are receiving immunosuppressive treatment).
Do not routinely send urine for culture in women with an uncomplicated urinary tract infection.
Ensure that the urine is collected and stored properly.
These guidelines concern me. Doctors are constantly being told to cut down on the number of antibiotics they prescribe yet it's a guessing game when they prescribe for a UTI if they don't send a urine specimen for C&S. The other concern is patients may be prescribed antibiotics they don't need.
Absolutely! I guess it's cheaper to throw a broad spectrum antibiotic at it to see if that works, but as you say, patients may well be given antibiotics they don't need, or antibiotics that won't do anything. And where we see the scenario of course after course given, with still no culture being done, there is something seriously wrong with the treatment being given. I was thinking it must be the condition of the vagina, with the atrophy that was causing a weakness, but now am wondering if that's absolutely nothing to do with it? But that is a question and not a statement.