AUTHORS: LCDR Kristina Polk, MD, CDR Michael Juliano, MD, Naval Medical Center Portsmouth. [email protected], 757-390-6720, Resident TITLE: Empiric Antibacterial Treatment for Women with Uncomplicated Lower Urinary Tract Infections OBJECTIVES: Urinary tract infection (UTI) is one of the most common clinical diagnoses in women, requiring antibacterial treatment for 1 in 3 women by age 24. Cystitis (lower UTI) is generally considered a benign condition with no long term sequelae. In this Emergency Department, about 10-12 patients are diagnosed with an uncomplicated lower UTI daily. The typical ED course for a patient presenting with symptoms consistent with simple UTI includes collection of a urine specimen, microscopic lab analysis, and frequently a urine culture and pelvic exam. These tests are time consuming and costly. Our study used an algorithm to empirically treat women with symptoms classically consistent with an uncomplicated lower UTI, and who were lacking symptoms of complicated or serious genitourinary diagnoses. METHODS: Between June 2012 and September 2013, 115 subjects were enrolled and empirically treated with Macrobid and Pyridium without urine collection or laboratory testing. Subjects were contacted 3 and 30 days after enrollment and polled on symptom resolution, need for additional medical visits, medication changes, adverse events, and patient satisfaction. RESULTS: All patients reported improvement on Day 3, with 86% reporting complete symptom resolution. The most common complication was recurrent UTI (8%). Only three patients were later diagnosed with other genitourinary conditions (2 urolithiasis, 1 PID). Patient satisfaction on a 1-10 scale averaged 9.7. CONCLUSION: We found that our algorithm could be used to safely and efficiently treat women with symptoms of uncomplicated lower UTI. Furthermore, we found that patient satisfaction was extremely high using this treatment algorithm.