Clinical uses of the leukocyte esterase test

In summary, there are many current and potential uses of the leukocyte esterase dipstick. However, the studies in the literature supporting these uses have several methodologic problems that should make one cautious about relying on the test too heavily. Its use in the symptomatic patient should be secondary to a urinalysis, especially in those who as a group have significant sequelae from urinary tract infections. These include pregnant patients, diabetics, and geriatric patients who may be lacking signs and symptoms of infection. The dipstick is not meant as a replacement for the microscopic examination of the urine sediment; it should be used to direct one to examine urine specimens that would not normally be analyzed microscopically. Further studies controlling for symptoms and gender are needed to make the leukocyte esterase test more useful to the primary care physician.