A practical guide to the management of complicated urinary tract infection

Drugs. 1997 Apr;53(4):583-92. doi: 10.2165/00003495-199753040-00004.

Abstract

Complicated urinary tract infections are infections in the setting of structural or functional abnormalities of the genitourinary tract. They encompass a wide variety of clinical syndromes and anticipated outcomes. The infecting micro-organisms isolated are more varied and demonstrate a higher prevalence of antimicrobial resistance in complicated compared to uncomplicated urinary tract infections. The usual duration of therapy is 7 to 14 days, although comparative trials to define optimal treatment duration are lacking. Long term success of antimicrobial treatment is dependent upon whether or not the underlying genitourinary abnormality can be corrected. Treatment of complicated urinary tract infections will usually be successful and may be permanent if the underlying abnormality can be corrected. If the underlying abnormality cannot be corrected, failure rates of 50% at 4 to 6 weeks following therapy are expected. Antimicrobial agents are similar to those used to treat uncomplicated urinary tract infection. Certain agents, such as nitrofurantoin, should be avoided for individuals with renal failure. No specific agent or class of agents has consistently demonstrated greater therapeutic efficacy where the infecting organism is susceptible to the given agent.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / microbiology
  • Gram-Positive Bacterial Infections / drug therapy*
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology

Substances

  • Anti-Infective Agents