In an adult woman with dysuria uncomplicated cystitis is very likely. Two diagnoses in the first place must not be missed: acute pyelonephritis and urethritis.

The user-friendliness of the stick and the unreliability of the classic urinary sediment explains the success of the leukocyte esterase test, although this test is mainly useful for the purposes of exclusion in combination with a negative nitrite test.

Short treatment regimens of three days are just as efficient as longer regimens with substantially less side-effects. A large number of products are found to be effective. We opt for trimethoprim or nitrofurans on the basis of the very broad international experience with these products without any significant problems.

The fluoroquinolones rapidly lead to the emergence of antibiotic resistance if used on a large scale. In general practice they are often the only alternative to parenteral treatment in complicated infections. We are therefore not in favour of their use in uncomplicated infections.