McIsaac et al developed a simple decision aid to help primary care providers treat women with acute cystitis. This can help to reduce unnecessary antibiotic therapy. The authors are from Mount Sinai Hospital, University of Toronto, University of Calgary and the Foothills Medical Centre.
Parameters:
(1) clinical dysuria
(2) dipstick leukocytes
(3) dipstick nitrates
Parameter
Finding
Points
dysuria
absent
0
present
1
dipstick leukocytes
negative or trace
0
1+ or above
1
dipstick nitrates
negative
0
trace or above
1
total score =
= SUM(points for the 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A patient with a score of 2 or 3 can be started on antibiotics.
• A patient with a score of 0 or 1 should have a urine culture taken and treatment based on the results of the culture.
Performance:
• The sensitivity was 80% and specificity 54%.
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