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

In the context of 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 follow-up is warranted to confirm the presence of a urinary tract infection (UTI) and identify the specific causative organism, which can guide appropriate antibiotic treatment.

Urine cultures are crucial when initial symptoms suggest a UTI, as they help in confirming the diagnosis and determining antibiotic susceptibility, especially in cases of recurrent infections or when symptoms are severe. This ensures that the treatment is effective and helps in preventing complications associated with untreated infections.

While STI testing is an important consideration in patients with urinary symptoms, it would not be the next immediate step in this scenario, especially without further evidence suggesting the suspicion of a sexually transmitted infection. A KUB x-ray and Pap smear would not be indicated in the workup for a UTI and would not provide the necessary information related to the symptoms presented.