Symptomatic UTI Protocol (Adults, Non-Pregnant)
1. Presentation & Urinalysis Checklist
Applicable for non-pregnant adults presenting with frequency, dysuria, hematuria, suprapubic pain, urgency, or polyuria.
Urinalysis Interpretative Tracks:
Perform a standard urinalysis and classify treatment according to the diagnostic metrics below.
Nitrite Positive (+ve)
- Probable UTI: Highly suggestive of bacterial involvement.
- Action: Initiate outpatient empiric antibiotic therapy.
Nitrite Negative (-ve)
Leukocyte Positive (+ve)
- Equally Likely DX: UTI or other differential diagnoses are equally likely.
- Review sampling technique and specimen time (morning sample is most reliable).
Nitrite Negative (-ve)
Leukocyte Negative (-ve)
- Unlikely UTI: Low probability of urinary infection.
- Action: Withhold antibiotics and consider alternative diagnoses (e.g., vaginitis).
2. Symptom Stratification (For Nitrite -ve / Leu +ve Cases)
Evaluate clinical symptom severity to determine immediate vs. delayed prescription logic.
Severe Symptoms
Patient presents with ≥ 3 symptoms suggestive of UTI:
- Manage actively with immediate empirical antibiotic therapy.
Non-Severe Symptoms
Patient presents with < 3 symptoms suggestive of UTI:
- Send a urine culture specimen to the lab.
- Consider a delayed antibiotic prescription strategy pending updates.
💊 Recommended Antimicrobial Dosage Directory
Outpatient prescription selections aligned with the National Antimicrobial Guideline.
| Antibiotic Option | Dosing Regimen | Duration | Remarks |
|---|---|---|---|
| Nitrofurantoin* |
50 – 100mg PO q6h (Immediate Release) OR 100mg PO q12h (Modified Release) |
5 Days |
Preferred Choice *Contraindicated if eGFR < 30 ml/min. |
| Cephalexin** | 500mg PO q6-12h | 5 Days |
Preferred Choice **Consider using q6h frequencies if the patient is at risk of a complicated UTI. |
| Amoxicillin / Clavulanate | 625mg PO q8h | 3 – 5 Days | Alternative |
| Ampicillin / Sulbactam | 375 – 750mg PO q12h | 3 – 5 Days | Alternative |
| Cefuroxime | 250 – 500mg PO q12h | 3 – 5 Days | Alternative |