Table 4

Nurse protocol for patients with lower urinary symptoms
Signs of alarm Symptoms for more than 7 days
Fever and/or chills
Pregnancy or lactation
Male sex
Age greater than 65
Diabetes mellitus
Recurrent urinary tract infection (≥ 2 infections within a 6-month period)
Recent urinary tract infection (less than 2 weeks)
Pyelonephritis within one year period
Bladder catheter
Vaginal discharge
Nausea and/or vomiting
Abdominal pain
Known abnormalities in urinary tract
Gross hematuria
Immunosuppressive therapy
Treatment approach 1. Amoxycillin-clavulanic acid 500/125 mg tid for 5 days or norfloxacin 400 mg bid for 3 days. Norfloxacin prescribed to patients with known allergy to penicillin.
2. Hygiene recommendations: cleanliness of the genital area, frequent bladder voiding, cotton-crotch underwear.
3. Return to consultation if signs of alarm develop (chills/fever, red urine, abdominal or lumbar pain…)

Fabrellas et al.

Fabrellas et al. BMC Family Practice 2013 14:61   doi:10.1186/1471-2296-14-61

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