urinary%20tract%20infection%20-%20complicated
URINARY TRACT INFECTION - COMPLICATED
Urinary tract infection (UTI) is complicated if the UTI is associated with factors that increases colonization and decreases therapy efficacy. Factors may include one or all of the following: Structural 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.
Principles of therapy includes effective antimicrobial antimicrobial therapy, optimal management of the underlying abnormalities or other diseases & adequate life-supporting measures.

Indications For Hospital Admission

  • The decision to hospitalize the patient will depend on the severity of the illness
Consider hospitalization if any of the following exist:
  • Patient w/ complicated urinary tract infection & unable to maintain oral hydration or take oral medications
  • Concerns regarding patient adherence to treatment
  • Uncertainty of diagnosis
  • Severe illness w/ high fever & severe pain
  • Marked debility & signs of sepsis
Outpatient
  • Patients who do not meet the above categories may be considered for treatment on an outpatient basis

Follow Up

  • Perform urine analysis to ensure that causative agent has been eradicated
  • A urine culture obtained 1-2 weeks after completing therapy & thereafter as clinically indicated may also be done
  • Further genitourinary investigation should be made in cases of:
    • Delayed or incomplete response to appropriate antimicrobial therapy
    • Early recurrence of infection after therapy
  • Further follow-up to identify & correct anatomical, functional or metabolic abnormalities is indicated
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
07 Jun 2018
Recurrent acute uncomplicated urinary tract infection (UTI) negatively affects quality of life (QOL), including physical and mental health status, in premenopausal women, according to a study. QOL may even be lower in UTI-infected women with comorbid chronic constipation or who consume caffeine.
Pank Jit Sin, 12 Jun 2018
The common antimicrobial agent, triclosan, has been implicated in colonic inflammation and the disease development of colitis and colitis-associated colon cancer, reveals a study appearing in Science Translational Medicine. [doi:10.1126/scitranslmed.aan4116] 
Roshini Claire Anthony, 30 May 2018

The use of procalcitonin assays had little impact on antibiotic exposure in patients who presented to emergency departments (ED) with suspected lower respiratory tract infections, according to findings of the ProACT* trial presented at the recent sessions of the American Thoracic Society (ATS 2018).