Proposed Algorithm for Evaluating Women with Symptoms of Acute Urinary Tract Infection (UTI)
Proposed Algorithm for Evaluating Women with Symptoms of Acute Urinary Tract Infection (UTI) - Flowchart
«Flowchart»

Eligible woman between the ages of 18 and 55 telephones or presents to clinic with predominant symptoms of dysuria or urinary urgency; she suspects she has a UTI.

Eligible woman between the ages of 18 and 55 telephones or presents to clinic with predominant symptoms of dysuria or urinary urgency; she suspects she has a UTI.

Eligible woman between the ages of 18 and 55 telephones or presents to clinic with predominant symptoms of dysuria or urinary urgency; she suspects she has a UTI.

End

End

End

Patient excluded from the pathway

Patient excluded from the pathway

Patient excluded from the pathway

Prescribe one from the following list:


    Nitrofurantoin monohydrate/macrocrystals (100 mg two times a day for 5 days); or
    Fosfomycin tromethamine (3 g once); or
    Ciprofloxacin (250 mg orally twice a day for 3 days); or
    Trimethoprim-sulfamethoxazole double-strength (two times a day for 3 days)

Prescribe one from the following list:


    Nitrofurantoin monohydrate/macrocrystals (100 mg two times a day for 5 days); or
    Fosfomycin tromethamine (3 g once); or
    Ciprofloxacin (250 mg orally twice a day for 3 days); or
    Trimethoprim-sulfamethoxazole double-strength (two times a day for 3 days)

Prescribe one from the following list:


    Nitrofurantoin monohydrate/macrocrystals (100 mg two times a day for 5 days); or
    Fosfomycin tromethamine (3 g once); or
    Ciprofloxacin (250 mg orally twice a day for 3 days); or
    Trimethoprim-sulfamethoxazole double-strength (two times a day for 3 days)

Nitrofurantoin monohydrate/macrocrystals (100 mg two times a day for 5 days); or
Fosfomycin tromethamine (3 g once); or
Ciprofloxacin (250 mg orally twice a day for 3 days); or
Trimethoprim-sulfamethoxazole double-strength (two times a day for 3 days)

Schedule visit with a health care provider

Schedule visit with a health care provider

Schedule visit with a health care provider

1  Primary exclusion criteria include documented fever 38°C; symptoms of dysuria or urgency ≥7 days; symptoms of vaginitis present; abdominal pain, nausea, or vomiting; gross hematuria in patients older than 50 years; immunosuppression (eg, current use of chemotherapeutic agents); diabetes mellitus; known pregnancy; chronic renal or urologic abnormalities, other than stress urinary incontinence (eg, polycystic kidney disease, neurogenic bladder, renal failure); recent or persistent urinary stones; urinary catheterization or other urologic procedure ≤2 wk ago; discharge from hospital or nursing home ≤2 wk ago; treatment for UTI ≤2 wk ago; recurrent symptomatic UTI.

1  Primary exclusion criteria include documented fever 38°C; symptoms of dysuria or urgency ≥7 days; symptoms of vaginitis present; abdominal pain, nausea, or vomiting; gross hematuria in patients older than 50 years; immunosuppression (eg, current use of chemotherapeutic agents); diabetes mellitus; known pregnancy; chronic renal or urologic abnormalities, other than stress urinary incontinence (eg, polycystic kidney disease, neurogenic bladder, renal failure); recent or persistent urinary stones; urinary catheterization or other urologic procedure ≤2 wk ago; discharge from hospital or nursing home ≤2 wk ago; treatment for UTI ≤2 wk ago; recurrent symptomatic UTI.

1  Primary exclusion criteria include documented fever 38°C; symptoms of dysuria or urgency ≥7 days; symptoms of vaginitis present; abdominal pain, nausea, or vomiting; gross hematuria in patients older than 50 years; immunosuppression (eg, current use of chemotherapeutic agents); diabetes mellitus; known pregnancy; chronic renal or urologic abnormalities, other than stress urinary incontinence (eg, polycystic kidney disease, neurogenic bladder, renal failure); recent or persistent urinary stones; urinary catheterization or other urologic procedure ≤2 wk ago; discharge from hospital or nursing home ≤2 wk ago; treatment for UTI ≤2 wk ago; recurrent symptomatic UTI.

1 ≥ ≤ ≤ ≤

Does patient meet any of the exclusion criteria?1 

Does patient meet any of the exclusion criteria?1 

Does patient meet any of the exclusion criteria?1 

1  1

Yes

Yes

Yes

No

No

No

Patient offered the option of either an office visit with a health care provider or telephone management.
Does the patient request an office visit?

Patient offered the option of either an office visit with a health care provider or telephone management.
Does the patient request an office visit?

Patient offered the option of either an office visit with a health care provider or telephone management.
Does the patient request an office visit?


Yes

Yes

Yes

No

No

No