urinary%20tract%20infection%20in%20women%20-%20complicated
URINARY TRACT INFECTION IN WOMEN - COMPLICATED
Complicated urinary tract infection (UTI) is associated with a condition [eg structural or functional abnormalities of the genitourinary tract (GUT)] or the presence of an underlying disease that interferes with host defense mechanisms, which increases the risks of acquiring infection, failing therapy or having recurrent infections. The successful treatment of a complicated UTI considers effective antimicrobial therapy, optimal management of the underlying abnormalities or other diseases and adequate life-supporting measures.

Urinary%20tract%20infection%20in%20women%20-%20complicated Management

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 with complicated UTI and unable to maintain oral hydration or take oral medications
  • Concerns regarding patient adherence to treatment
  • Uncertainty of diagnosis, eg suspected urinary tract obstruction
  • Severe illness with high fever and severe pain
  • Marked debility and 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 and 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 and correct anatomical, functional or metabolic abnormalities as indicated
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