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People with an asymptomatic urinary tract infection (UTI) should not be prescribed antibiotics, according to new NICE guidance.
The guidance is designed to “limit the prescription of unnecessary antibiotics which may increase anti-microbial resistance to certain treatments,” according to Dr Paul Chrisp, director of Centre for Guidelines at NICE.
However, antibiotics should still be prescribed to both men and women who have two or more key urinary symptoms and no other excluding causes or warning signs.
What are the symptoms of a UTI?
According to the NHS, UTIs affect your urinary tract, including your bladder, urethra and/or kidneys. Symptoms include: pain or a burning sensation when passing urine, needing to urinate more often and more urgently than usual, urine that looks cloudy, dark or has a strong smell and blood in the urine.
Older, frail people who have problems with memory, learning and concentration, and people with a urinary catheter may have different symptoms of a UTI, including delirium, incontinence and rigors.
UTIs can be ‘uncomplicated’ – when there is an infection in the lower urinary tract, the bladder and urethra – or ‘complicated’ – when the infection extends beyond the bladder to the kidneys.
Women are at higher risk of experiencing kidney infections
The new NICE guidance states that non-pregnant women with an uncomplicated lower UTI should be prescribed a 3-day course of antibiotics, and men and pregnant women with an uncomplicated lower UTI should be prescribed a 7‑day course of antibiotics.
However, men and women with a recurrent UTI (and women with a recurrent lower UTI where the cause is unknown) should be referred for specialist advice.
This is because women have a shorter urethra than men and bacteria is more likely to reach the bladder or kidneys and cause an infection.
The guidance also states that:
- Women aged under 65 with two or more key urinary symptoms and adults with indwelling urinary catheters do not require a dipstick test.
- The number of episodes of a suspected UTI should be recorded in the patient’s records.
- Recurrent UTIs should be recorded in the patient’s records.
Reducing time patients spend in discomfort and pain
Dr Chrisp says the new quality standard is designed to “improve the diagnosis and management of UTIs” in order to improve quality of life for people experiencing UTIs.
By setting out clear methods for the diagnosis of UTIs, the guidance aims to reduce the rate of misdiagnosis and limit the prescription of unnecessary antibiotics “which may increase anti-microbial resistance to certain treatments,” according to Dr Chrisp.
“This quality standard sets out useful and usable guidance for health professionals to improve the diagnosis and management of UTIs in both women and men,” he concludes.