title: Top Ten Myths Regarding the Diagnosis and Treatment of Urinary Tract Infections.
abstract: BACKGROUND
  Urinary tract infections (UTI) are the most common type of infection in the United States. A Centers for Disease Control and Prevention report in March 2014 regarding antibiotic use in hospitals reported "UTI" treatment was avoidable at least 39% of the time. The accurate diagnosis and treatment of UTI plays an important role in cost-effective medical care and appropriate antimicrobial utilization.
  
  
  OBJECTIVE
  We summarize the most common misperceptions of UTI that result in extraneous testing and excessive antimicrobial treatment. We present 10 myths associated with the diagnosis and treatment of UTI and succinctly review the literature pertaining to each myth. We explore the myths associated with pyuria, asymptomatic bacteriuria, candiduria, and the elderly and catheterized patients. We attempt to give guidance for clinicians facing these clinical scenarios.
  
  
  CONCLUSIONS
  From our ambulatory, emergency department, and hospital experiences, patients often have urine cultures ordered without an appropriate indication, or receive unnecessary antibiotic therapy due to over-interpretation of the urinalysis.
  
  
  CONCLUSIONS
  Asymptomatic bacteriuria is common in all age groups and is frequently over-treated. A UTI diagnosis should be based on a combination of clinical symptoms with supportive laboratory information. This review will assist providers in navigating common pitfalls in the diagnosis of UTI.
authors.affiliation: Infectious Diseases and Critical Care Clinical Pharmacy, University of Wisconsin Hospital and Clinics, Madison, Wisconsin.
authors.forename: Lucas
authors.initials: L
authors.lastname: Schulz
authors.affiliation: Hospital Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hoffman
authors.affiliation: Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Pothof
authors.affiliation: Infectious Diseases, University of Wisconsin School of Medicine and Public Health, Clinical Science Center, Madison, Wisconsin.
authors.forename: Barry
authors.initials: B
authors.lastname: Fox
mesh_terms: D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006801:Humans; D009812:Odorants / Q000032:analysis; D010465:Perception; D016482:Urinalysis / Q000379:methods* / Q000592:standards; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*
keywords: UTI; antimicrobial; asymptomatic bacteriuria; cystitis; diagnosis; stewardship; treatment; urinalysis; urinary tract infection