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Drugs & Aging

, Volume 18, Issue 4, pp 243–254 | Cite as

A Practical Guide to Antimicrobial Management of Complicated Urinary Tract Infection

  • Lindsay E. NicolleEmail author
Therapy in Practice

Abstract

Complicated urinary tract infection occurs in the setting of a functionally or structurally abnormal genitourinary tract. Many different abnormalities may lead to a designation of complicated urinary tract infection, and these abnormalities will have different influences on the frequency of infection and likelihood of relapse or reinfection. The microbiology of complicated urinary tract infection is characterised by a greater variety of organisms and increased likelihood of antimicrobial resistance compared with acute uncomplicated urinary tract infection.

Appropriate management requires a urine specimen for culture prior to institution of antimicrobial therapy, and ensuring that the underlying abnormality is fully characterised to determine whether it can be corrected. A wide variety of antimicrobial agents are effective for treatment, and are usually given for 7 to 14 days. If the underlying abnormality can be corrected, subsequent infections may be prevented. However, if the underlying abnormality cannot be corrected a high recurrence rate of infection, approaching 50% by 4 to 6 weeks, is expected. Further study of complicated urinary tract infection is necessary, including determination of when asymptomatic bacteriuria warrants treatment, and exploration of nonantimicrobial approaches to management.

Keywords

Urinary Tract Infection Antimicrobial Therapy Bacteriuria Neurogenic Bladder Genitourinary Tract 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Adis International Limited 2001

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of Manitoba, Health Sciences CentreWinnipegCanada

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