Scope and Target Population:

To facilitate the triage and appropriate treatment for women age 18-65 with uncomplicated urinary tract infection.

Clinical Highlights and Recommendations:

• Assess all women ages 18-65 with symptoms of UTI for the presence of complicating factors. The presence of complicating factors warrant provider evaluation, and may require additional diagnostic work-up.
  
• Patients who have classic symptoms of urinary tract infection and no complicating factors can be offered the option of phone treatment, if preferred by both provider and patient.
  
• If laboratory evaluation is preferred by the provider, symptomatic women without complicating factors can be appropriately evaluated by a urinalysis rather than a urine culture.
  
• Symptomatic women without complicating factors can be effectively treated with the following recommended therapy:
  -Trimethoprim sulfamethoxazole D.S. 1 twice daily x 3 days
  -Trimethoprim 100 mg 1 twice daily x 3 days
  If allergic to sulfa or trimethoprim:
  -Nitrofurantoin (Macrobid) 100 mg twice daily x 7 days
  -Ciprofloxacin 250 mg BID x 3 days
  Sulfa and ciprofloxacin may cause an increase in INR values for patients taking warfarin.
  
• All patients should be provided patient education about the prescribed therapy, and the need to return to clinic if the symptoms do not subside.

Priority Aims:

1. Decrease the use of urine culture as a guide in therapy of uncomplicated UTI.
   
2. Increase the use of short course therapy in women with uncomplicated UTI.
   
3. Increase patient satisfaction with management of uncomplicated UTI.