Absence of symptoms and negative dipstick results do not rule out infection in patients with suspected UTI, a primary care study has found. The researchers aimed to identify which clinical features and dipstick variables independently predict laboratory diagnosis of UTI, and to validate clinical decision rules based on these independent predictors. A total of 434 women with suspected UTI were recruited to the study from practices in the south of England. They were asked to rate the presence of symptoms and their severity. A midstream urine specimen was examined for cloudiness to the naked eye, and offensive odour, before urine dipstick testing was carried out. 'GPs need to be aware that in a patient with suspected UTI, absence of classic symptoms or negative dipstick results do not reliably rule out the presence of infection. Thus, alternative strategies are required for these patients, whether arranging clinical review if symptoms persist or the use of delayed prescriptions.'