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UTI vs asymptomatic bacteriuria — DGM MCQ

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EasyContinenceUTI vs asymptomatic bacteriuriaDGM

An 87-year-old woman in a care home has a positive urine dipstick found during routine screening. She has no dysuria, fever, suprapubic pain or new confusion. She is eating and drinking normally. Current medicines include amlodipine. What is the most appropriate management?

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Correct answer: D — Do not treat asymptomatic bacteriuria

A positive dipstick without urinary or systemic symptoms in an older woman is likely asymptomatic bacteriuria and should not be treated. Antibiotics, hospital transfer, catheterisation and pyelonephritis diagnosis are not justified by screening alone. Overtreating asymptomatic bacteriuria causes harm and resistance.

Reference: NICE UTI antimicrobial prescribing guidance