There's an excellent commentary on urinary tract infections in the American Journal of Medicine by Tom Finucane, one of my professors from medical school, who is a superb general internist and geriatrician. He argues that UTIs are overdiagnosed and overtreated, and notes that uncomplicated cystitis is usually self-limited, as evidenced by the billions of persons who have recovered from UTIs without antibiotics. And he cites recent studies that challenge the long-held dogma that urine is normally sterile.
What is needed, Dr. Finucane tell us, is a paradigm shift on how we think about UTI. To that end, he suggests "that authors use “UTI” only within quotation marks and that clinicians use the bimanual “air quotes” gesture in discussions. This small, repetitive annotation is intended to disrupt the term’s complacent usage and encourage rethinking of how one manages bacteriuria."
On reading his commentary, I couldn't help but think of posts on the blog over the past few months that question the importance of and even the existence of