[The Dutch College of General Practitioners' guideline on urinary tract infections: response from the viewpoint of family practice].

Asymptomatic bacteriuria in healthy non-pregnant women is common, mostly transient and benign, whilst antimicrobial drug treatment is highly successful in women with a symptomatic and uncomplicated urinary tract infection. So, from a practical point of view the need to treat could be solely based on patients' preferences and symptoms. Yet recent Dutch professional guidelines have chosen an objective diagnosis based on the examination of a urine sample, although consensus is still lacking as to the most effective and efficient diagnostic method. In the debate about predictive values and the practical consequences of the various methods, the differences in the pathological backgrounds of the tests can easily be overlooked. Bacteriuria and inflammatory response have a causal connection, but reflect distinct phenomena. Symptoms do not necessarily result from the former but may result from the latter. Attention needs to be paid to these triangular correlations in future studies.