Rethinking the urinalysis
In one of the first issues of the new SHEA journal, Sonali Advani and colleagues make the case that the lowly urinalysis should be reconsidered.
“Urinalysis evolved over the last 200 years to include different chemical analyses and microscopic examination, making it a compilation of unaligned tests that only have their specimen source in common.”
“Overuse of urinalysis in different settings, with 60-80% of urinalyses being ordered in patients without symptoms referable to the GU tract.”
“Pyuria occurs in 32% of young women, 90% of elderly patients in long-term care facilities, and 90% of hemodialysis patients.”
Pyuria often leads to antibiotics, even in patients without symptoms of UTI, a condition known as asymptomatic bacteriuria (ASB).
Can we break up the UA into the questions it helps answers, and not provide misleading information if not desired? Sounds great. Here’s what they propose:
Urinalysis Components That Can Be Ordered In Lieu of Complete Urinalysis (UA)
Advani, S., Polage, C., & Fakih, M. (2021). Deconstructing the urinalysis: A novel approach to diagnostic and antimicrobial stewardship. Antimicrobial Stewardship & Healthcare Epidemiology, 1(1), E6. doi:10.1017/ash.2021.167
