Urine culture should be ordered for which type of patient?

The appropriate choice is for a patient with complicated cystitis. In the context of urinary tract infections, complicated cystitis typically refers to cases where the infection occurs in the presence of underlying conditions, such as structural abnormalities of the urinary tract, the presence of foreign bodies (like urinary catheters), or systemic conditions that may influence the course of the infection. These patients are at a higher risk for treatment failure and have the potential for more serious complications than those with uncomplicated cases.

By ordering a urine culture for these patients, healthcare providers can identify the specific bacteria causing the infection and determine their sensitivity to antibiotics, guiding effective treatment. This is crucial in complicated cystitis to ensure the chosen antibiotic is effective and to avoid the risk of further complications.

In contrast, mild cystitis typically may not warrant a urine culture as it often can be treated empirically without identifying the specific pathogens. Similarly, a patient experiencing urinary retention might have an underlying symptom that needs to be assessed but does not intrinsically require a culture unless there's clinical suspicion of a significant infection. Lastly, individuals without symptoms generally do not necessitate a urine culture since they are not exhibiting signs of an active infection.