Abstract
The extensive use of the urinalysis for screening and monitoring in diverse clinical settings usually identifies abnormal urinalysis parameters in patients with no suspicion of urinary tract infection, which in turn triggers urine cultures, inappropriate antimicrobial use, and associated harms like Clostridioides difficile infection. We highlight how urinalysis is misused, and suggest deconstructing it to better align with evolving patterns of clinical use and the differential diagnosis being targeted. Reclassifying the urinalysis components into infectious and non-infectious panels and interpreting urinalysis results in the context of individual patient’s pretest probability of disease is a novel approach to promote proper urine testing and antimicrobial stewardship, and achieve better outcomes.
Highlights
The urinalysis is a popular screening test used across a wide range of inpatient and outpatient clinical settings, due to ease of accessibility, rapidity of results, and low cost
Nitrite has poor sensitivity and specificity for diagnosing a urinary tract infection (UTI).[18] (3) Microscopic examination of the urine enables confirmation of urine dipstick findings and the identification of structures that are not evaluated by the urine dipstick
Detection of bacteria on the microscopic examination may be associated with positive urine cultures, but it cannot differentiate between asymptomatic bacteriuria, contamination, and UTI
Summary
The urinalysis is a popular screening test used across a wide range of inpatient and outpatient clinical settings, due to ease of accessibility, rapidity of results, and low cost. It is useful in the diagnosis and progression of wide range of medical conditions such as renal calculi, metabolic disorders, diabetes, acute and chronic kidney diseases, infections, stroke, and malignancy.[11,12] Urinalysis evolved over. Urinalysis is overused to diagnose urinary tract infections in patients with nonspecific symptoms like confusion, fever, abdominal pain or sepsis without genitourinary symptoms This has led to overuse of urinalysis in different settings, with 60%–80% of urinalyses being ordered in patients without symptoms referable to the genitourinary tract.[15,16,17]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Antimicrobial Stewardship & Healthcare Epidemiology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
