If you’ve ever visited a clinician or healthcare provider with suspected UTI symptoms, chances are you were sent home with antibiotics before any test results came back, or you were told to wait several days for urine culture results before receiving any treatment guidance at all. 

UTIs are among the most common bacterial infections worldwide, affecting an estimated 400 million people every year. In the UK, they are the second most common reason for prescribing antibiotics in primary care, making UTIs a significant driver of antimicrobial resistance (AMR). Yet the UTI diagnostic tools routinely used at the point of care remain largely unchanged: an outdated urine dipstick test and a culture that takes two to three days and requires a laboratory.

Despite being considered the gold standard UTI test in clinical practice, the standard urine culture (SUC) frequently fails to detect clinically relevant bacteria. SUC misses up to 67% of uropathogens and offers no timely guidance on antibiotic susceptibility. For patients, this means days of uncertainty, delayed treatment, prolonged pain and repeated visits to healthcare services. 

New point-of-care (POC) UTI testing aims to close this gap, giving clinicians the information they need to prescribe the right antibiotic, at the right time, during the same clinic visit. Here, we explore the POC technologies currently being assessed, how they could transform patient outcomes, and what this means for clinical practice.

How POC Testing Aims to Improve Patient Outcomes

For individuals experiencing UTI symptoms, the need for quick and effective treatment is essential. Delays in diagnosis often mean that patients are left in pain or discomfort, and are unable to continue with their usual daily activities, creating a significant impact on their quality of life.

Rapid POC testing is designed to provide patients with accurate answers during their first healthcare visit. By identifying the microbes involved and recommending which antibiotics are likely to be effective, POC testing eliminates the need to wait days for results or rely on an antibiotic that may not be the right choice.

Prolonged diagnostic uncertainty, repeated trips to healthcare providers, and multiple antibiotic courses that fail to clear an infection are all common experiences for those living with recurrent or chronic UTI. POC antibiotic susceptibility testing (AST) has the potential to end what many describe as “just‑in‑case” prescribing, in which antibiotics are prescribed based on regional antibiotic resistance patterns rather than information specific to the individual patient. Instead, AST supports targeted, evidence‑based treatment that is more likely to work the first time.

Beyond the individual, POC testing strengthens antibiotic stewardship at scale. Reducing unnecessary or inappropriate antibiotic use is one of the most effective strategies for slowing the development of AMR, a public health threat the World Health Organization identifies as one of the greatest challenges of our time. AMR caused an estimated 1.27 million deaths globally in 2019, and projections suggest this could rise to 10 million deaths annually by 2050 if current trends continue.

Giving the right antibiotic as quickly as possible improves patient outcomes, not only in terms of the time it takes for symptoms to get better, but in terms of rare but significant complications like sepsis and hospital admissions

– Dr Brown, Consultant Medical Microbiologist at Cambridge University Hospitals

The Role of POC Testing

POC testing for UTI sits at the intersection of patient experience, clinical decision‑making, and public health. Its core contributions include:

• Faster answers – reducing uncertainty and enabling same‑day treatment decisions.

• More accurate treatment – matching antibiotics to the microbes actually present.

• Fewer unnecessary antibiotics – helping clinicians avoid broad‑spectrum or ineffective prescribing.

• Improved patient experience – fewer repeat appointments, fewer treatment failures, clearer care pathways, and most importantly, improved quality of life.

• Support for AMR reduction – contributing to national and global stewardship goals.

Promising Point-of-Care UTI Testing Technologies 

A number of innovative technologies are currently being developed and clinically evaluated to bring faster, more accurate UTI diagnostics into primary care and outpatient settings. In 2023, the National Institute for Health and Care Excellence (NICE) assessed 12 POC technologies as part of its early value assessment on tests designed to improve antimicrobial prescribing for urinary tract infections.

NICE grouped these technologies into two main categories:

• Rapid tests, which provide results in 45 minutes
• Culture-based tests, which typically provide results within 16–24 hours

These technologies use a variety of approaches to identify bacteria, detect infection markers, or determine antibiotic susceptibility.

Rapid Point-of-Care Tests

Rapid POC technologies are designed to support clinical decision-making during a patient appointment, reducing the delay between testing and treatment.

Examples of rapid POC tests being assessed by NICE include:

• Sysmex Astrego – PA-100 AST System
• Llusern Scientific – Lodestart DX
• Inflammatix – TriVerity
• Savyon Diagnostics – Uriscreen
• Global Access Diagnostics – UTRiPLEX

A range of rapid diagnostic approaches is emerging to support more accurate, timely decision‑making in UTI care. Antimicrobial susceptibility testing (AST) technologies assess how the organisms present respond to commonly used UTI antibiotics in as little as 45 minutes, compared with the two to three days required for standard urine culture. 

Rapid bacterial identification tests are able to detect key uropathogens directly from urine within approximately 40 minutes, offering faster clarity on the likely cause of symptoms. 

Blood‑based infection tests distinguish between bacterial and viral infections and provide an indication of severity in around 30 minutes. 

Finally, biomarker‑ and enzyme‑based urine tests detect host or bacterial enzymes associated with infection in just a few minutes, providing an immediate indication of inflammatory activity or bacterial presence at the point of care.

Culture-Based Point-of-Care Tests

Culture-based POC tests still rely on bacterial growth, but they are designed to be used closer to the patient rather than in a central laboratory.

These systems generally provide results in 16–24 hours, which is still faster and potentially more accessible than standard laboratory workflows in some settings.

Examples of culture-based tests assessed by NICE include:

• Flexicult Human
• Uricult
• Uricult Trio
• Uricult Plus
• Diaslide
• DipStreak
• ChromoStreak

Some of these systems can:

• Detect bacterial growth
• Quantify bacterial levels
• Identify common UTI-causing organisms
• Assess susceptibility to selected antibiotics

Why These Technologies Matter

NICE noted that current UTI diagnosis often relies on symptom assessment, dipstick testing, and delayed laboratory culture results. Because laboratory susceptibility testing can take several days, antibiotics are frequently prescribed before results are available.

Clinical and patient experts consulted by NICE highlighted several potential benefits of newer point-of-care technologies, including:

• Faster access to effective treatment
• Reduced unnecessary antibiotic use
• Fewer repeat urine samples
• Improved support for people with recurrent or chronic UTI
• Better antimicrobial stewardship

However, NICE also noted that more evidence is still needed to understand how accurately these technologies perform across different patient groups, including people with recurrent UTIs, catheter-associated infections, and older adults.

How could POC testing change clinical practice?

The introduction of rapid POC testing into primary care settings would represent a significant shift in how UTIs are managed – not just for patients, but for clinicians too.

Currently, clinicians manage a suspected UTI with limited options:

• Treat empirically at the time of appointment, and risk inappropriate antibiotic choice
• Wait for culture results, risking a delay in effective treatment and prolonging symptoms and discomfort for patients
• Refer the patient to a specialist for further investigation

POC antibiotic susceptibility testing allows clinicians to treat a UTI more confidently during the same visit, based on accurate data about the individual patient. Ultimately, this could reduce the need for follow-up appointments and repeat prescriptions, reducing pressure on health services. 

Point-of-care systems are designed to be operable without specialist laboratory training, meaning they can function in a surgery or walk-in clinic, rather than requiring a hospital or lab. 

Antibiotic prescribing decisions for UTIs are often made under time pressure, with limited diagnostic information. Knowing that a test has recommended a specific antibiotic as effective against the organism/s identified in a patient’s urine reduces much of the uncertainty.

The Longitude Prize on AMR

Established by Challenge Works in 2014, the Longitude Prize on AMR was launched to encourage the development of rapid, accurate, and affordable diagnostic tests that could help address antimicrobial resistance. 

The challenge was clear: develop an affordable, accurate, rapid, and easy-to-use test for bacterial infections that would allow healthcare professionals to prescribe the right antibiotic at the right time. 

More than 250 teams have entered the competition over a ten-year period. In 2024, the PA-100 AST System developed by Sysmex Astrego was named the winner.

The PA-100 AST System by Sysmex: A Longitude Prize Winner

Sysmex Astrego, a subsidiary of Sysmex Corporation, was awarded the £8 million Longitude Prize on AMR for the development of the PA-100 AST System.

Sysmex developed a POC testing system, which provides clinicians with targeted antibiotic prescriptions within 45 minutes. 

The PA-100 AST System is a rapid testing device used to assess whether your urine sample contains harmful bacteria. If bacteria are detected, the system identifies which antibiotics are most likely to treat the infection. Instead of waiting days for traditional culture results, the system provides answers during the same visit.

Within 15 minutes, the device indicates whether a bacterial infection is present. If bacteria are detected, antibiotic susceptibility results follow within 45 minutes of the start of the test. Following EUCAST standards, results indicate whether the identified organisms are susceptible or resistant to the following five commonly prescribed antibiotics: 

• Amoxicillin/clavulanic acid
• Ciprofloxacin
• Fosfomycin
• Nitrofurantoin
• Trimethoprim

The PA-100 AST System ensures patients receive personalised, targeted antibiotic guidance within 45 minutes, allowing clinicians to make informed treatment decisions during the same visit. This rapid approach helps ensure that treatment is tailored to the specific bacteria found in the sample, supporting more confident and timely care and promoting responsible antibiotic use.

The Future of UTI Care: Bringing Diagnostics Closer to the Patient

Point‑of‑care UTI testing represents more than a technological upgrade – it signals a shift toward faster, more personalised, and more accountable infection management. For patients, this means fewer delays, fewer ineffective antibiotic courses, and a clearer path to recovery. For clinicians, it offers the confidence to prescribe based on real‑time evidence rather than regional AMR patterns, reducing uncertainty. And for healthcare systems, it provides a practical route to improving antimicrobial stewardship at scale, while reducing the economic burden of repeat appointments, unnecessary prescribing, and follow-up care.

Ultimately, improving UTI care requires a combination of better diagnostics, better prescribing, and better patient support. Point‑of‑care testing is a critical part of that shift, offering a pathway toward treatment that is faster, safer, and more aligned with the needs of the millions of people affected by UTIs each year.

Disclaimer: This article is intended to provide general information only and does not replace professional medical advice.