Monitoring
16
STEP 11: Monitoring of Individuals Treated and At Risk
for UTI
➤ Monitor vital signs, oral intake, cognition and function for response to
therapy and/or opportunities for de-escalation as above.
➤ Check results of urine culture as specified above and adjust
antimicrobial therapy based on clinical status and susceptibility
results, when indicated ("antibiotic time-out").
➤ Follow labs, including renal profile and drug levels, as clinically
indicated and/or based on antimicrobial agent guidelines.
➤ Obtaining post-treatment urine cultures ("test-of-cure") is not
recommended.
➤ Surveillance cultures of those with urinary catheters or recurrent
UTI's is not recommended.
➤ Chronic/long-term prophylactic antibiotic therapy is not
recommended to prevent recurrence of UTI in both catheterized and
non-catheterized individuals; while antibiotics may reduce the risk of
recurrent uncomplicated UTI's, the potential harms associated with
long-term use, coupled with the prevalence of multidrug resistant
organisms among PALTC residents, argues against this practice.
➤ For postmenopausal women, local (vaginal) estrogen therapy should
be considered for the prevention of recurrent UTI's as well as to treat
atrophic vaginitis, the symptoms of which often mimic UTI.
