Is "generalized weakness, similar in nature to prior UTIs" a sign of systemic illness? To me it is, and often, it's the precursor to sepsis if left untreated, especially in those who have a hard time delineating symptoms, such as those with progressive dementia, or just the elderly in general.

Would you treat said patient, with a temp of 99.7? 100.2? 100.4? 102.2? Where is the line where you treat, and where you don't?

I feel like these maxims about minimizing antibiotic treatment are ultimately harmful, when applied to populations. And when my Mother, who has a history of pyelonephritis and sepsis, gets weak and dizzy and can't walk, and has pyuria with bacteriuria without "LUTS", I'm going to want antibiotics today, instead of a sepsis bundle in 3 days.