Suspected urinary tract infection (UTI) syndromes are a common reason for empirical antibiotics to\nbe prescribed in the Emergency Department (ED), but differentiating UTI from other conditions with a similar\npresentation is challenging. We investigated how often an ED diagnosis of UTI is confirmed clinically/\nmicrobiologically, and described conditions which present as UTI syndromes.\nMethods: Observational study using electronic health records from patients who attended the ED with suspected\nUTI and had a urine sample submitted for culture. We compared the ED diagnosis to diagnosis at discharge from\nhospital (ICD-10 codes), and estimated the proportion of cases with clinical/microbiological evidence of UTI.\nResults: Two hundred eighty nine patients had an ED diagnosis of UTI syndrome comprising: lower UTI (191),\npyelonephritis (56) and urosepsis (42). In patients admitted to hospital with an ED diagnosis of lower UTI,\npyelonephritis or urosepsis, clinical/microbiological evidence of UTI was lacking in 61/103, 33/54 and 31/42 cases\nrespectively. The ED diagnosis was concordant with the main reason for admission in less than 40% of patients\nwith UTI syndromes, and antibiotics were stopped within 72 h in 37/161 patients..............
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