De diagnostiek van urineweginfecties bij verpleeghuispatienten revisited: Is 'sticken' zinvol?

An urine dipstick (nitrite and/or leucocyte esterase) is frequently used in nursing homes as diagnostic instrument when patients display signs and symptoms of an UTI. Prospectively was registered which signs and symptoms of UTIs lead to an urine dipstick test and if the results altered the pre-test diagnosis. Furthermore were recorded the incidence of UTIs, the accompanying signs and symptoms, and the antibiotic treatment given. Dipstick assessments of urine (n=74) were all positive (nitrite and/or leucocyte-esterase) and did not alter the pre-test UTI-diagnosis. All dipstick assessments were followed by antibiotic treatment. UTI incidence was 0.48/resident-year. Prescription of antibiotics was guided by an antibiotic formulary. Only a small minority needed non-formulary antibiotics.