JAMA Netw Open

New triage guide aims to optimize UTI evaluation in virtual and in-person care

February 11, 2026

A multidisciplinary panel reviewed literature from 2009 to 2024 and rated 1,094 management scenarios for suspected UTI in nonpregnant adult women and men. Using the RAND/UCLA Appropriateness Method, experts assessed the appropriateness of empiric antibiotics, urine testing, and visit types. Key recommendations included same‑day in‑person evaluation for symptoms concerning for pyelonephritis, complicated cystitis, or urinary obstruction; a visit for patients with additional nonurinary symptoms; and no urine testing or empiric treatment for isolated changes in urine appearance. Empiric treatment without testing or a visit was deemed appropriate for women with new classic cystitis symptoms and no risk factors for antibiotic resistance. Urinalysis with culture was recommended before treatment for women at resistance risk and all men.

Clinical takeaway: Consider applying these appropriateness criteria to guide urine testing, empiric treatment decisions, and visit type selection for adults with suspected UTI.

Source:

Meddings J, et al. (2026, January 2). JAMA Netw Open. Ann Arbor Guide to Triaging Adults With Suspected Urinary Tract Infection for In-Person and Telehealth Settings. https://pubmed.ncbi.nlm.nih.gov/41609831/