Management of Uncomplicated Urinary Tract Infections

Diagnosis and Treatment

The American College of Physicians recommends that asymptomatic patients after treatment completion do not require routine post-treatment urinalysis or urine cultures, as this practice can lead to overtreatment of asymptomatic bacteriuria 1
Symptom clearance alone is adequate evidence of successful treatment in uncomplicated UTI 1

For patients with symptoms that do not resolve by the end of treatment, or symptoms that initially resolve but recur within 2 weeks after completing antibiotics, repeat urine culture is indicated 1
For patients with persistent or recurrent symptoms, obtain both urine culture AND antimicrobial susceptibility testing to guide further management 1
The American Academy of Family Physicians suggests that if the initial presentation included hematuria, repeat urinalysis 48 hours after cessation of potential benign causes, and 6 weeks after treatment if hematuria was associated with UTI 2

For patients with repeated infections from struvite stone-forming bacteria, obtain imaging studies to rule out urinary calculi 1
Persistent hematuria after infection treatment warrants complete urologic evaluation 2