Table 4 Nurse protocol for patients with lower urinary symptoms
Signs of alarm | Symptoms for more than 7 days |
Fever and/or chills | |
Pregnancy or lactation | |
Male sex | |
Age greater than 65 | |
Diabetes mellitus | |
Recurrent urinary tract infection (≥ 2 infections within a 6-month period) | |
Recent urinary tract infection (less than 2 weeks) | |
Pyelonephritis within one year period | |
Bladder catheter | |
Vaginal discharge | |
Nausea and/or vomiting | |
Abdominal pain | |
Known abnormalities in urinary tract | |
Gross hematuria | |
Immunosuppressive therapy | |
Treatment approach | 1. Amoxycillin-clavulanic acid 500/125 mg tid for 5 days or norfloxacin 400 mg bid for 3 days. Norfloxacin prescribed to patients with known allergy to penicillin. |
2. Hygiene recommendations: cleanliness of the genital area, frequent bladder voiding, cotton-crotch underwear. | |
3. Return to consultation if signs of alarm develop (chills/fever, red urine, abdominal or lumbar pain…) |