Complicated UTI/MalesJump to Therapy Menu
Complicated UTI associated with functional and anatomical abnormalities of the genitourinary (GU) tract including:
- Obstructive uropathies - strictures, tumors/cysts, stones, prostatic hypertrophy, congenital abnormalities.
- Recent GU instrumentation - cystoscopy/urologic procedures, catheterization, ureteric stent, nephrostomy tubes.
- Delayed/impaired voiding - neurogenic bladder, vesicoureteral reflux, ileal conduit, cystocele.
- Metabolic abnormalities - renal failure/dysfunction, nephrocalcinosis, poorly controlled diabetes.
- Immunocompromised states - renal transplant, neutropenia, HIV
- Males - UTIs are typically considered complicated as functional or anatomical abnormalities are often present.
Exception: males with first time UTI related to sexual activity.
Urologic work-up recommended in males with recurrent cystitis, pyelonephritis, and all young boys.
- Asymptomatic bacteriuria is common in the elderly and does NOT require antibiotic therapy.
- If febrile, do blood culture.
- Pre treatment urine cultures recommended. Post treatment cultures to ensure clearance not generally recommended unless upper urinary tract obstruction.
- Consultation with microbiologist or Infectious Diseases physician recommended for all culture negative recurrent UTIs.