A patient presents with burning, frequency, and urgency. With a UA showing positive leukocytes, what should be ordered next?

For a patient presenting with symptoms of burning, frequency, and urgency, along with a urinalysis (UA) showing positive leukocytes, the next appropriate step is to order a urine culture. This is essential because it allows for the identification of the specific organism causing the urinary tract infection (UTI), which is suggested by the presence of leukocytes. A urine culture can provide valuable information about the bacteria present and help determine the appropriate antibiotic treatment based on sensitivity testing.

This step is critical, especially given the potential for antibiotic resistance; knowing the specific pathogen will guide the clinician to choose the most effective therapy, minimizing the risk of ineffective treatment. Urine culture is the gold standard for diagnosing UTIs and confirms the diagnosis, which is particularly important if the initial empirical treatment does not lead to clinical improvement.