There is now unprecedented emphasis on reducing the number of medical tests and costs. In this issue, Kaplan et al have presented a thoughtful attack on the routine dipstick, the simplest component of the time-honored urinalysis. They clearly recognize its use in identifying suspected pathologic states in symptomatic patients such as glycosuria (diabetes mellitus), positive nitrite or leukocyte esterase (urinary tract infection), heavy proteinuria (nephrotic syndrome and significant intrarenal disease), or blood (pink/red/brown urine). However, using reasonable assumptions, they estimate that minimal costs for screening dipsticks and follow-up costs for initial positive findings ranged between ∼$5000 and $6500 per year for a population of 2000 children. They conclude that the routine dipstick may provide transient or false-positive results, generate unnecessary evaluation, and should be eliminated. We agree in principle with the authors. In our view, routine testing of infants is unnecessary and, thus, cost of bags, cultures, and urinalysis...

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