[Urinary tract infections: which studies? Whom to treat?]

Urinary tract infections are a common problem seen in ambulatory practices. For this reason it is important to have a cost-effective management. Clinical history and findings may allow to make the diagnosis. The laboratory costs can be reduced, if in case of cystitis a rapid test for detection of leucocytes replaces the urine culture. Urine cultures can be restricted to patients with complicated urinary tract infections. Single-dose with cotrimoxazole or 3-day treatment with trimethoprim is adequate for acute cystitis. The new quinolones are useful for the outpatient treatment of benign cases of acute pyelonephritis. In case of urethritis and prostatitis, the same drugs have an appropriate antimicrobial spectrum and an ideal bioavailability in the infected tissues.