Acute Complicated UTI

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Acute Complicated UTI
Definition Signs/ Symptoms Urosepsis or Acute urinary tract obstruction
Antibiotic
Acute UTI accompanied by features that suggest extension beyond the bladder "Fever(>37.7 C) Chills, Rigors, Significant fatigue Flank pain, Costovertebral angle tenderness Pelvic or perineal pain in male symptoms of cystitis may or may not be present"

Select one of the following antibiotics:

  • Imipenem/Cil 500 mg I.V every 6 hours ( Infuse over 3 hours)
  • Meropenem 1- 2 g I.V every 8 hours ( Infuse over 3 hours)
Other Hospitalized patients
First Line Options

Select one of the following antibiotics:

  • Ceftriaxone 2 g I.V every 24 hours
  • Levofloxacin 750 mg I.V every 24 hours
  • Ciprofloxacin 400 mg I.V every 12 hours
Second Line Options

Select one of the following antibiotics:

  • Piperacillin/Tazo 4.5 g I.V every 6 hours
  • Cefepime 2 g I.V every 8 hours
Duration: Urosepsis/ Acute urinary tract obstruction: 7- 14 days , Other hospitalized patients: 5- 10 days
References:

IDSA Guideline on Management and Treatment of Complicated Urinary Tract Infections 2025