Overview
Complicated urinary tract infection (UTI) is UTI associated with factors that increases colonization and decreases therapy efficacy. Factors may include anatomical or functional abnormalities of the genitourinary tract, presence of an underlying disease that interferes with host defense mechanisms or the patient being immunocompromised, and being infected by a multi-drug resistant bacteria.
The successful treatment of a complicated UTI involves optimal
antimicrobial therapy, appropriate management of underlying
abnormalities or diseases, and adequate life-supporting measures. The selection of a specific antimicrobial agent is based upon
clinical presentation, the known or suspected microorganism and its
susceptibilities, local resistance data, patient's tolerance or
allergies, documented efficacy and in some cases, cost. Patients with complicated UTIs generally require 7-14 days of antimicrobial therapy.
May consider treatment for 7 days if patient is hemodynamically stable and afebrile for at least 48 hours. Oral antibiotic therapy may be started in stable patients. Initial parenteral therapy is preferred only for individuals who
have symptoms requiring hospitalization: Hemodynamic instability,
nausea, vomiting, questionable absorption or an infection by suspected
resistant organisms for which oral therapy is not available.
Patients may be switched to appropriate oral therapy within
72 hours if with clinical improvement and if can tolerate oral
medications.
For further information regarding the management of Urinary Tract Infection - Complicated, please refer to Disease Algorithm for the Treatment Guideline.
