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Urinary tract infection (lower) - men - Management
How should I follow up a man with lower urinary tract infection?
- Review after 48 hours (or according to the clinical situation) to check response to treatment and the culture results.
- If urine culture shows that the organism is resistant to the current antibiotic, change to an antibiotic that the organism is sensitive to.
- If symptoms have resolved by the time the culture result is available, consider continuing with the current antibiotic, and doing a 'test of cure' urine culture after completing treatment. If symptoms then recur, treat with an antibiotic shown to cover the infecting organism.
- Consider if there are any risk factors that need to be excluded or managed.
- Consider referral for specialist urological assessment when the man has recovered from the acute infection.
Basis for recommendation
- These recommendations are pragmatic, as there is no evidence from clinical trials or published expert opinion.
- Continuing the initial antibiotic is recommended when urine culture reveals a resistant uropathogen and the man's symptoms have resolved, because either the infection is resolving on its own or the organism is susceptible despite the laboratory assessment of resistance.
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