WEDNESDAY, Feb. 4, 2026 (HealthDay News) -- In a consensus statement published online Feb. 2 in JAMA Network Open, the appropriateness of empiric antibiotics, urine testing, and clinical evaluation options are considered for adults presenting with concerns for urinary tract infection (UTI) in ambulatory triage situations.
Jennifer Meddings, M.D., from the Veterans Affairs Ann Arbor Healthcare System in Michigan, and colleagues examined the appropriateness of different triage and management recommendations for adults with suspected UTI. A scoping review of the literature was performed and the appropriateness of 136 clinical scenarios was rated, with up to nine management strategies for each scenario.
Major recommendations included same-day in-person evaluation if symptoms are concerning for pyelonephritis, complicated cystitis, or urinary obstruction. If additional nonurinary symptoms are present, a visit is also recommended. Neither urine testing nor empiric treatment is recommended solely due to a change in urine color or appearance without additional bladder (cystitis) symptoms. For women, empiric treatment is recommended without testing or a visit if there are new classic cystitis symptoms of dysuria, urinary frequency, urgency, or suprapubic pain without risks for antibiotic resistance. For women at risk for antibiotic resistance and all men, urinalysis with culture is recommended before taking a first antibiotic dose. For patients with barriers to obtaining timely urine testing or visits, the authors recommend empiric treatment be considered.
"We hope that this guide will help both patients and providers be aware that even though they're now able to take a questionnaire or interact with a provider completely virtually, that alone may not be enough to get the right diagnosis or treatment," Meddings said in a statement.
One author disclosed ties to the Blue Cross Blue Shield of Michigan Clinical Quality Committee.