Use of dipsticks when diagnosing UTI

Avoid treating asymptomatic bacteriuria - "Skip the dip"

In patients older than 65 years, do not perform urine dipsticks for the diagnosis of UTI. Dipsticks become unreliable in older age. Approximately half of older adults and almost all patients with urinary catheters will have bacteria in the urine without an infection (Asymptomatic bacteriuria).

To diagnose and treat UTI in patients older than 65 years always:-

• Document clinical symptoms and signs
• Do not use dipsticks (although a negative dipstick can be useful in RULING OUT UTI)
• Follow OUH guidelines when prescribing antibiotics
• Send pre-treatment urine to the lab for culture
• If a urinary catheter is in place, the need for this should be reviewed and documented

For UTI in elderly and/or frail patient: see UTI + functional decline