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Reply to "Refused treatment for UTI"
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[quote=Anonymous]I'm a nurse practitioner and treat UTIs. The person you saw may have practice guidelines she is obligated to follow (like waiting for culture results) but here's how I handle these: If someone has mild/vague sx ("I'm peeing more frequently" or "my pee has a weird smell") but not acutely uncomfortable I will send the culture and then treat based on results. That is a day or 2 turnaround so reasonable if suspicion is low/symtpoms are mild. However if symptoms are classic for UTI and/or patient is very uncomfortable I will go ahead and treat with one of the first line recommended antibiotics at time of visit. As someone said above most UTIs are caused by E.coli and we have a good handle on which meds they are most likely to respond to. Someone above made point that doctors offices can have culture "in minutes." This isn't true. The thing we do that takes a few minutes is a macro urinalysis which is just one of those little sticks that you dip in urine with squares that turn different colors (for white blood cells, protein, glucose etc.) These can be very helpful in confirming UTIs but they are imperfect and also give us no info about an antibiotic match if that is a concern. As many have pointed out, in health care we try to be judicious with use of antibiotics and not just prescribe at the slightest of something being not right, much as many patients want that. And things that feel like UTIs can be other things, I have lots of patients tell me they have a UTI and end up with a negative culture. At the same time when someone is experiencing acute discomfort and presenting with classic symptoms I always offer treatment. It's a balancing act.[/quote]
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