![]() Symptoms and a urine culture with a bacterial count of more than100 CFU per mL of urine Three-day course is best Quinolones may be used in areas of TMP-SMX resistance or in patients who cannot tolerate TMP-SMX Urinalysis for pyuria and hematuria (culture not required) Asymptomatic bacteriuria rarely requires treatment and is not associated with increased morbidity in elderly patients. ![]() Complicated infections are diagnosed by quantitative urine cultures and require a more prolonged course of therapy. The most effective therapy for an uncomplicated infection is a three-day course of trimethoprim-sulfamethoxazole. These infections can be empirically treated without the need for urine cultures. ![]() Uncomplicated urinary tract infections are caused by a predictable group of susceptible organisms. Further categorization of the infection by clinical syndrome and by host (i.e., acute cystitis in young women, acute pyelonephritis, catheter-related infection, infection in men, asymptomatic bacteriuria in the elderly) helps the physician determine the appropriate diagnostic and management strategies. Initially, a urinary tract infection should be categorized as complicated or uncomplicated. Recent studies have helped to better define the population groups at risk for these infections, as well as the most cost-effective management strategies. Urinary tract infections remain a significant cause of morbidity in all age groups.
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