Dipstick urinalysis for the diagnosis of acute UTI

Approximately two-thirds of women who present with classic symptoms of acute UTI have bacterial infection of the bladder. Dipstick urinalysis moderately improves the accuracy of clinical symptoms in establishing or excluding acute UTI in women. (Strength of Recommendation [SOR]: A, based on systematic reviews of cross-sectional studies and a validated clinical decision rule.) A positive nitrite test is more useful than a positive leukocyte esterase (LE) test, although both increase the odds of a UTI diagnosis. If nitrite and LE tests are negative, the odds of a UTI decrease by 40 to 60 percent. (SOR: A, based on systematic reviews of cross-sectional studies including men and women.