Title: Urinary Tract Infections in Adults - American Family Physician
Headings: Urinary Tract Infections in Adults
Urinary Tract Infections in Adults
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Adult Urinary Tract Infection
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Urinary Tract Infections in Adults
Acute Uncomplicated Cystitis in Young Women
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Diagnostic Tests for Urinary Tract Infections in Women with Dysuria
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Antibiotic Therapy for Urinary Tract Infections
Recurrent Cystitis in Young Women
Complicated UTI
Uncomplicated Pyelonephritis
UTI in Men
Catheter-Associated UTI
Asymptomatic Bacteriuria
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Continue reading from March 1, 1999

Content: The microbiology of uncomplicated cystitis is limited to a few pathogens. As many as 90 percent of uncomplicated cystitis episodes are caused by Escherichia coli, 10 to 20 percent are caused by coagulase-negative Staphylococcus saprophyticus and 5 percent or less are caused by other Enterobacteriaceae organisms or enterococci. 3 In addition, the antimicrobial susceptibilities of these organisms are highly predictable. Up to one third of uropathogens are resistant to ampicillin and sulfonamides, but the majority are susceptible to trimethoprim-sulfamethoxazole (85 to 95 percent) and fluoroquinolones (95 percent). 3, 11
In view of the limited spectrum of causative organisms and their predictable susceptibility, urine cultures and susceptibility testing add little to the choice of antibiotic for the treatment of acute uncomplicated cystitis in young women. Therefore, urine cultures are no longer advocated as part of the routine work-up of these patients. Instead, these patients should undergo an abbreviated laboratory work-up in which the presence of pyuria is confirmed by traditional urinalysis (wet