When to do culture in urinary tract infections

A brief review of the value of quantitative bacteriology of the urine in pa tients with symptoms of urinary tract infections is presented. Changes in o ur approach to the diagnosis of urinary tract infections are briefly discus sed. The economic value of empiric treatment without urine cultures in youn g women with dysuria and frequency is presented along with our approach to patients with asymptomatic bacteriuria in the presence of an indwelling bla dder catheter. In addition, specific groups of patients with symptomatic ur inary tract infections who require urine cultures in order to receive optim al antimicrobial therapy is reviewed. Although these suggestions may not be appropriate for all patients in each category, their use in some patients is likely to result in economic benefits without reducing the quality of th eir health care. (C) 1999 Published by Elsevier Science B.V. All rights res erved.