Urinary Tract Infection & Pyelonephritis

Urinary Tract Infection & Pyelonephritis



Preferred Therapy

  • Isolation of significant colony counts (>10⁵) of bacteria in the urine from a person WITHOUT symptoms of a UTI
  • Lacks common symptoms of cystitis, pyelonephritis, and catheter-associated UTI
  • No evidence suggests that delirium, falls, or confusion are symptoms of a UTI in the absence of urinary symptoms
  • Acute cystitis in non-pregnant female
  • Functional or structural abnormalities
    • E.g. male, pregnant women, children, hospitalized, nephrolithiasis, diabetes, renal insufficiency, indwelling catheter and immunosuppression
  • Uncomplicated infection that fails to respond to appropriate therapy
  • Upper tract involvement
  • Sepsis
  • Presence of signs/symptoms of UTI with NO OTHER identified source of infection
  • Along with >10³ CFU/ml of >1 bacterial species in a single catheter urine specimen in a midstream voided urine specimen from a patient with those catheter has been removed within previous 48 hours

Clinical Considerations

  • Avoid using the same antibiotic if recurrent UTI within 3 months
  • If same organism, consider CT scan to rule out abscess or stone
  • Look for urinary retention, presences of stones, devices
  • Consider cystoscopy to detect biofilms

Consider gonococcal cystitis and chlamydia infection