If simple UTI then just treat based on Sx (no dip or MSU, 3/7 Abs) Sx - frequency, dysuria, ?pain ? unwell (90% with these will have UTI) Trimethoprim or Nitrofurantoin If complicated then need MSU (guide treatment if no response) and 7/7 Abs ie - male, >65, pregnant, significantly unwell (fever, loin pain) Co-Amoxiclav, Ciprofloxacin Test of cure Dipstick - poor accuracy - doesn't help over Sx use if unclear Sx, if ?STI, or other possible diagnosis (eg stone) if catheter or >65 dipstick is usually positive so doesn't help Pregnancy ? Beware Trimethoprim - folate deficiency Use Cephalexin or Nitrofurantoin Screening culture at booking - do second culture to confirm as aSx and then Rx (7/7 and test of cure (3-4 days post Rx) Repeat MSU at every visit as 30% get upper UTI which inc risk Men - remember orchitis or prostatitis and STI MSU, Chlamydia, Gonnorhoea ?PR for prostatitis ?refer if poor response or second UTI Nitrofurantoin - beware skin rash and reduce dose in renal impairment Recurrent >3 in 12/12 ?post coital Abs, regular Abs eg daily trimethoprim