Antibiotics for the urinary tract are not indicated

• See AGS Choosing Wisely, consider printing patient information

If a urinalysis and culture were obtained:

PEARL – The presence of pyuria does not diagnose an infection and the absence of pyuria rules out a UTI (except in a severe leukopenic state)
PEARL – Up to 50% of older adults in long term care facilities will be colonized and bacteriuric. In the absence of symptoms, this does not indicate a UTI and often represents asymptomatic bacteriuria.

Pursue further evaluation and treatment of localizing symptoms. Reevaluate if new symptoms arise, existing symptoms do not resolve, or not etiology for symptoms is found after comprehensive evaluation

If in hospital or long-term care, implement active monitoring. Example:

• Trend vital signs every 8-12 hours
• Monitor hydration status, encourage fluids by mouth
• Repeat physical assessments by hospital or nursing home staff