To the Editor.
—I was pleased to see the article by Bachman et al1 regarding the various tests to detect asymptomatic urinary tract infections (AUTIs). I have long been a proponent of Gram's stain of the spun urinary sediment as the prime method for diagnosing UTI. It is inexpensive and fast and can be done in the office as part of the office visit. It saves the health care system a lot of money, and I am suspicious that this is the reason that it has not succeeded.There is little need for performing urine cultures in the office. If Gram's stain of the spun urinary sediment is positive, the patient can be treated 98% of the time with an inexpensive drug such as trimethoprim in combination with a sulfa drug or nitrofurantoin, since practically all organisms seen in outpatients are easily treated. If Gram's stain of the spun
Keeler LL. Tests to Detect Asymptomatic Urinary Tract Infections. JAMA. 1994;271(18):1399. doi:10.1001/jama.1994.03510420031013