Vitalité Health Network logo
Guidelines
Urinary Tract Infections

Urinary Tract Infections

Assessment

When to Send a Urine for Culture and Urinalysis

Positive Urine Culture Assessment Algorithm

Treatment

Treatment of Adult UTIs

More Information

Attribution

Guideline content derived from NB Provincial Health Authorities Anti-Infective Stewardship Committee Guidelines:

  • Treatment of Adult Urinary Tract Infections, 02-2021.

  • When to Send a Urine for Culture and Urinalysis, 02-2021.

  • Positive Urine Culture Assessment Algorithm, 02-2021.

References
  1. Blondel-Hill E. & Fryters S. (2012). Bugs & Drugs An Antimicrobial/Infectious Diseases Reference. Alberta Health Services.
  2. Nicolle LE, Bradley S, Colgan R et al. Infectious Diseases Society of America Guidelines for the Diagnosis and Treatment of Asymptomatic Bacteriuria in Adults. Clinical Infectious Diseases 2005; 40:643-654.
  3. Gupta K, Hooton TM, Naber KG et al. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: a 2010 Update by the Infectious Diseases Society of America and European Society for Microbiology and Infectious Disease. Clinical Infectious Diseases. 2011; 52(5):e103-120
  4. Hooton TM, Bradley SF, Cardenas DD et al. Diagnosis, Prevention, and Treatment of Catheter Associated Urinary Tract Infections in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clinical Infectious Diseases. 2010; 50:625-663
  5. Hynes NA. (2013) John Hopkins Antibiotic Guide: Urinary Tract Infections in Pregnancy. Retrieved from: http://www.hopkinsguides.com/hopkins/ub/view/Johns_Hopkins_ABX_Guide/540572/all/Urinary_Tract_Infections_in_Pregnancy
  6. Hynes NA. (2013) John Hopkins Antibiotic Guide: Pyelonephritis, Acute, Uncomplicated. Retrieved from: http://www.hopkinsguides.com/hopkins/ub/view/Johns_Hopkins_ABX_Guide/540458/all/Pyelonephritis__Acute__Uncomplicated
  7. Hynes NA. (2013) John Hopkins Antibiotic Guide: Bacterial Cystitis, Acute, Uncomplicated. Retrieved from: http://www.hopkinsguides.com/hopkins/ub/view/Johns_Hopkins_ABX_Guide/540046/all/Bacterial_Cystitis__Acute__Uncomplicated
  8. Hynes NA. (2013) John Hopkins Antibiotic Guide: Urinary Tract Infection, Complicated(UTI). Retrieved from: http://www.hopkinsguides.com/hopkins/ub/view/Johns_Hopkins_ABX_Guide/540573/all/Urinary_Tract_Infection__Complicated__UTI_
  9. Coyle E.A., Prince R.A. (2011). Chapter 125. Urinary Tract Infections and Prostatitis. In R.L. Talbert, J.T. DiPiro, G.R. Matzke, L.M. Posey, B.G. Wells, G.C. Yee (Eds), Pharmacotherapy: A Pathophysiologic Approach, 8e. Retrieved February 21, 2013 from http://www.accesspharmacy.com.libpublic3.library.isu.edu/content.aspx?aID=8004270.
  10. Sobel JD & Kay D. (2010) Chapter 69. Urinary Tract Infections. In Gerald L Mandell. Mandell, Douglas, and Bennett’s Priniciples and Practice of Infectious Disease. 7th Edition. Retrieved February 4, 2013 from http://www.expertconsultbook.com/expertconsult/p/book.do?method=display&eid=4-u1.0-B978-0-443-06839-3..X0001-X--TOP&isbn=978-0-443-06839-3&selectBook=true&decorator=none&type=aboutPage&showPremiumLinkForBasic=true&hasPremiumTitle=true#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-0-443-06839-3..00069-2%3Bfrom%3Dtoc%3Btype%3DbookPage%3Bisbn%3D978-0-443-06839-3&search=none
  11. PL Detail-Document, Choosing a UTI Antibiotic for Elderly Patients. Pharmacist’s Letter/Prescriber’s Letter. December 2011.
  12. Oplinger M and Andrews CO. Nitrofurantoin Contraindication in Patients with a Creatinine Clearance below 60 mL/min: Looking for the Evidence. Ann Pharmacother 2013; 47:106-11
  13. Gupta K, Hooton TM, Roberts PL et al. Short-Course Nitrofurantoin for the Treatment of Acute Uncomplicated Cystitis in Women. Arch Intern Med. 2007;167(20):2207-2212
  14. Sanchez M, Collvinent B, Miro O et al. Short-term Effectiveness of Ceftriaxone single dose in the initial treatment of acute uncomplicated pyelonephritis in women. A randomized control trial. Emerg Med J 2002;19:19-22
  15. Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD003237. DOI: 10.1002/14651858.CD003237.pub2.
  16. Lutters M, Vogt-Ferrier NB. Antibiotic duration for treating uncomplicated, symptomatic lower urinary tract infections in elderly women. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD001535. DOI: 10.1002/14651858.CD001535.pub2.
  17. Zalmanovici Trestioreanu A, Lador A, Sauerbrun-Cutler MT, Leibovici L. Antibiotics for asymptomatic bacteriuria. Cochrane Database of Systematic Reviews 2015, Issue 4. Art. No.: CD009534. DOI: 10.1002/14651858.CD009534.pub2.
  18. Milo G, Katchman E, Paul M, Christiaens T, Baerheim A, Leibovici L. Duration of antibacterial treatment for uncomplicated urinary tract infection in women. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD004682. DOI: 10.1002/14651858.CD004682.pub2.
  19. Zalmanovici Trestioreanu A, Green H, Paul M, Yaphe J, Leibovici L. Antimicrobial agents for treating uncomplicated urinary tract infection in women. Cochrane Database of Systematic Reviews 2010, Issue 10. Art. No.: CD007182. DOI: 10.1002/14651858.CD007182.pub2.
  20. Grigoryan L, Trautner BW, Gupta K. Diagnosis and management of urinary tract infections in the outpatient setting: a review. JAMA. 2014 Oct 22-29;312(16):1677-84. doi: 10.1001/jama.2014.12842.
  21. INESSS Publications. Urinary Tract Infections in Adults, October 2009. http://www.inesss.qc.ca/fileadmin/doc/CDM/UsageOptimal/Guides-serieI/CdM-Antibio1-UrinaryTractInfections-Adults-en.pdf Accessed January 5, 2017
  22. Hooton TM and Gupta K. Urinary Tract Infections and Asymptomatic Bacteriuria in Pregnancy. UpToDate https://www.uptodate.com/contents/urinary-tract-infections-and-asymptomatic-bacteriuria-in-pregnancy?source=search_result&search=pregnancy%20uti&selectedTitle=1~150# Last Accessed May 16, 2017
  23. Hooton TM and Gupta K. Acute complicated urinary tract infection (including pyelonephritis) in adults. UpToDate https://www.uptodate.com/contents/acute-complicated-urinary-tract-infection-including-pyelonephritis-in-adults. Lastg updated August 21, 2019
  24. Harris AD et al. Risk Factors for Colonization with Extended-Spectrum β-Lactamase–producing Bacteria and Intensive Care Unit Admission. Emerging Infectious Diseases. Volume 13, Number 8 – August 2007. (https://wwwnc.cdc.gov/eid/article/13/8/07-0071_article)
  25. Glatt A. Three risk factors associated with community-acquired ESBL UTIs. Infectious Disease News January 9, 2019
  26. Huttner A. et al. Effect of 5-Day Nitrofurantoin vs Single-Dose Fosfomycin on Clinical Resolution of Uncomplicated Lower Urinary Tract Infection in Women: A Randomized Clinical Trial. JAMA. 2018 May 1;319(17):1781-1789.
  27. Goodlet KJ, Benhalima FZ and Nailor MD. A systematic review of single-dose aminoglycoside therapy for urinary tract infection: Is it time to resurrect an old strategy? DOI: 10.1128/AAC.02165-18