Anonymous wrote:

Anonymous wrote: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.

Are you only prescribing antibiotics based on the results of the urinalysis? Or are you providing them if the patient is describing severe symptoms?

Anonymous wrote: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.

Anonymous wrote:

Anonymous wrote:Infections kill people. Infections that hang around untreated while an arrogant, cookbook, insecure, in knowledgeable “health care practitioner” waits for confirmatory labs are more likely to kill people.

Part of the art of medicine is the knowledge, experience and confidence to make a good judgment and begin treatment and then have the diagnosis confirmed or adjusted when the labs come back.

There is no excuse for how you were treated. You need a new primary care PHYSICIAN.

Ok alarmist. Did you know UTIs can clear on their own? Did you know only a small fraction lead to a kidney infection? Most patients can safely wait until the culture comes back with pain relief. Not all but most. It is the pain and discomfort that need to be treat immediately.

Ear infections and UTIs are over medicated. They have pulled back on automatic antibiotics for ear infections and are finally beginning with UTIs.

Anonymous wrote:Next time go to a walk-in clinic or an urgent care clinic, not the ER, for a minor emergency like a UTI.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I have a ton of experience with UTI's and no your doctor should absolutely be able to culture and tell you within minutes whether you have one.

Get a new doctor.

Also, CVS Minute clinics and or any urgent care would be better than your current doctor. They are idiots.

If the longer culture comes back negative then they should send you to a URO GYN not no antibiotics. There would be an underlying reason for the pain.

Are you saying that the culture results can come back in minutes, or am I misreading you?

I think they mean the doctor’s office can determine if bacteria is present in the urine during the office visit. The actual culture to see how the bacteria reacts to the antibiotics is not immediate.

Thanks, but I was trying to determine what PP meant by writing that, and I'm still interested in PP's response.

What are you “trying to determine”? Are you conducting an investigation? It’s quite clear what PP meant.

I was asking what PP meant by writing what was written. It's not an insult, but you seem to be taking offense. Why so defensive?

You really cannot understand what the PP wrote?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Clinics have definitely been cracking down on prescribing antibiotics for UTIs with the urine culture. This will be particularly true if you are a middle aged, or older, woman because you can have UTI symptoms that are not caused by bacteria. I have had a urine culture that came back negative. I both think it is responsible for providers to see the urine culture before giving out antibiotics, and I get how frustrating it is as the patient to be waiting for days to get relief.

This. I can't believe you wouldn't respect a provider being responsible. I have chronic UTIs now (thank perimenopause). So I got in, leave a sample, then head right to CVS to get some Uritstat. It starts working really quickly and gives me pain relief. Then I wait a day or maybe 2 for the culture to come back. The reason we have to do this is because of patients like OP who is demanding antibiotics STAT.

For a UTI that was confirmed by urgent care? How is that a problem for you?

It’s not confirmed until there is a culture. I was getting urinary pain every couple months about 8 years ago and it was NEVER actually a UTI. We shouldn’t be taking antibiotics at the drop of a hat because it wasn’t helping me and it was actively harming the rest of the population. Never did figure out what was causing the pain, but it all ended up resolving on it’s own.

Anonymous wrote:Next time go to a walk-in clinic or an urgent care clinic, not the ER, for a minor emergency like a UTI.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Clinics have definitely been cracking down on prescribing antibiotics for UTIs with the urine culture. This will be particularly true if you are a middle aged, or older, woman because you can have UTI symptoms that are not caused by bacteria. I have had a urine culture that came back negative. I both think it is responsible for providers to see the urine culture before giving out antibiotics, and I get how frustrating it is as the patient to be waiting for days to get relief.

This. I can't believe you wouldn't respect a provider being responsible. I have chronic UTIs now (thank perimenopause). So I got in, leave a sample, then head right to CVS to get some Uritstat. It starts working really quickly and gives me pain relief. Then I wait a day or maybe 2 for the culture to come back. The reason we have to do this is because of patients like OP who is demanding antibiotics STAT.

For a UTI that was confirmed by urgent care? How is that a problem for you?

Anonymous wrote:

Anonymous wrote:Clinics have definitely been cracking down on prescribing antibiotics for UTIs with the urine culture. This will be particularly true if you are a middle aged, or older, woman because you can have UTI symptoms that are not caused by bacteria. I have had a urine culture that came back negative. I both think it is responsible for providers to see the urine culture before giving out antibiotics, and I get how frustrating it is as the patient to be waiting for days to get relief.

This. I can't believe you wouldn't respect a provider being responsible. I have chronic UTIs now (thank perimenopause). So I got in, leave a sample, then head right to CVS to get some Uritstat. It starts working really quickly and gives me pain relief. Then I wait a day or maybe 2 for the culture to come back. The reason we have to do this is because of patients like OP who is demanding antibiotics STAT.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I have a ton of experience with UTI's and no your doctor should absolutely be able to culture and tell you within minutes whether you have one.

Get a new doctor.

Also, CVS Minute clinics and or any urgent care would be better than your current doctor. They are idiots.

If the longer culture comes back negative then they should send you to a URO GYN not no antibiotics. There would be an underlying reason for the pain.

Are you saying that the culture results can come back in minutes, or am I misreading you?

I think they mean the doctor’s office can determine if bacteria is present in the urine during the office visit. The actual culture to see how the bacteria reacts to the antibiotics is not immediate.

Thanks, but I was trying to determine what PP meant by writing that, and I'm still interested in PP's response.

What are you “trying to determine”? Are you conducting an investigation? It’s quite clear what PP meant.

I was asking what PP meant by writing what was written. It's not an insult, but you seem to be taking offense. Why so defensive?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I have a ton of experience with UTI's and no your doctor should absolutely be able to culture and tell you within minutes whether you have one.

Get a new doctor.

Also, CVS Minute clinics and or any urgent care would be better than your current doctor. They are idiots.

If the longer culture comes back negative then they should send you to a URO GYN not no antibiotics. There would be an underlying reason for the pain.

Are you saying that the culture results can come back in minutes, or am I misreading you?

I think they mean the doctor’s office can determine if bacteria is present in the urine during the office visit. The actual culture to see how the bacteria reacts to the antibiotics is not immediate.

Thanks, but I was trying to determine what PP meant by writing that, and I'm still interested in PP's response.

What are you “trying to determine”? Are you conducting an investigation? It’s quite clear what PP meant.