Trend of Erythrocyte Sedimentation Rate in Patients with Symptomatic Urinary Tract Infection Under Treatment

Objectives: The aim of this study was to evaluate erythrocyte sedimentation rate (ESR) in patients with symptoms of urinary tract infection (UTI), and to analyze bacte- riological and clinical findings. Methods: In a prospective study, 187 patients with UTI and suggestive signs and symptoms were included. History of UTI and clinical findings were recorded. Urine specimens were cultured and analyzed for pyuria by sediment microscopy and nitrite using a test strip. The systemic inflammatory response was assessed by ESR, and total white blood cell count. Results: Escherichia coli accounted for 62.2% of the urinary isolates. Most UTI patients showed a decline three days after treatment, whereas some had an increased ESR response at this time (despite improvements in clinical symptoms). Overall, ESR on the sixth day was determined to be a better marker for response to symptomatic UTI treatment than the third day ESR. Conclusions: This study showed that ESR and clinical findings were not interchangeable indexes of patient's condition, although they are concordant (both normal and both abnormal) in the vast majority of patients. Erythrocyte sedimentation rate is frequently misleading in patients with UTI and is not responsive to changes in the patient's condition. Checking ESR is recommended not earlier than six days after starting UTI treatment, if necessary.