Working aged-women should only be diagnosed with a water infection if they have at least two symptoms, health officials have said. Doctors have been told that they should only give a diagnosis if women under 65 have two “key symptoms” of infection – including a burning pain when passing urine, needing to wee more at night and “cloudy” urine.
New advice on diagnosing urinary tract infections (UTIs) also warns that medics should rule out other causes before diagnosing a UTI. The National Institute for Health and Care Excellence (Nice) said that diagnosing UTI’s correctly will “support appropriate management” and reduce the unnecessary use of antibiotics.
It also made recommendations on the length of time adults should be put on antibiotics to treat “uncomplicated” bladder infections, also known as cystitis. Women should have a three-day course of antibiotics while men and pregnant women should be prescribed a seven-day course of treatment, Nice said.
It said short courses of treatment for women can reduce their risk to antibiotic resistance and are “sufficient” for treating most UTIs. Men have a higher risk of complications from UTIs than women – which mean they need a longer course of treatment, Nice added. And pregnant women are at “greater risk of harm from a UTI than non-pregnant women”.
Women have a shorter urethra than men, this means that bacteria are more likely to reach the bladder or kidneys and cause an infection. Because of this, no specific recommendations have been made for trans people and GPs are urged to consider treatment courses on a case-by case basis – including information on any gender reassignment surgery and structural changes to a person’s urethra.
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Meanwhile, men and women who are not pregnant do not need antibiotic treatment if a UTI is picked up but they have no symptoms.
“Unnecessary antibiotic treatment of asymptomatic bacteriuria is associated with increased risk of adverse events and is of no clinical benefit,” the Nice quality standard states. Meanwhile Nice said that certain patients with recurrent UTIs should be referred for specialist advice
Dr Paul Chrisp, director of Centre for Guidelines at Nice, said: “UTIs are a common occurrence, but they can cause people a great amount of discomfort and pain. For people with recurrent UTIs this can lead to a reduction in their quality of life.
“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 while also setting a clear treatment pathway for people with a recurrent UTI who are at higher risk of complications.
“The standard will also help ensure that people are not misdiagnosed.
“By setting out clear methods for the diagnosis of UTIs, it will help limit the prescription of unnecessary antibiotics which may increase anti-microbial resistance to certain treatments.”
Previous guidance from Public Health England in 2020 suggests that women under 65 who present with two or more symptoms of a UTI do not need to use a dipstick test to confirm their infection.
