Management of Complicated Urinary Tract Infections
Summary
Complicated urinary tract infections (UTIs) arise in the setting of structural or functional abnormalities of the urinary tract, often involving indwelling devices, obstruction or reflux. These infections carry a higher risk of treatment failure and recurrence owing to a broader spectrum of pathogens, including multidrug-resistant organisms. Management begins with thorough clinical and radiological assessment to identify underlying anatomical factors. Urine culture and susceptibility testing guide the selection of empirical and definitive antimicrobial regimens, which may include intravenous administration for severe presentations. Source control—such as relief of obstruction or removal of catheter—is essential to prevent relapse. Recent advances support shorter or oral treatment courses in stable patients when the pathogen profile and pharmacodynamics allow. Point-of-care diagnostics and stewardship frameworks aim to tailor therapy, reduce adverse effects and curb antimicrobial resistance. Collaboration between urology, infectious disease and microbiology teams ensures individualised care plans and contributes to global efforts against resistant uropathogens.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Management of Complicated Urinary Tract Infections publication trend
The graph below shows the total number of articles in management of complicated urinary tract infections across all publications each year (not limited to Nature Index journals).
Technical terms
Complicated urinary tract infection: Infection occurring in the presence of structural or functional urinary tract abnormalities or comorbidities that increase the risk of treatment failure.
Source control: Interventions to remove or correct the underlying anatomical or device-related cause of infection, such as catheter removal or relief of obstruction.
Extended-spectrum β-lactamase (ESBL): Enzymes produced by certain bacteria that confer resistance to penicillins, cephalosporins and monobactams, complicating antimicrobial selection.
Antimicrobial stewardship: A coordinated strategy to optimise antibiotic use, improve patient outcomes and limit the emergence of resistance.
Point-of-care Gram stain: A rapid diagnostic technique performed at the patient’s bedside to identify bacterial morphology and inform early antibiotic choices.
References
- Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review. Antibiotics (2023).
- Point-of-care urine Gram stain led to narrower-spectrum antimicrobial selection for febrile urinary tract infection in adolescents and adults. BMC Infectious Diseases (2022).
- Treatment of complicated urinary tract infection and acute pyelonephritis by short-course intravenous levofloxacin (750 mg/day) or conventional intravenous/oral levofloxacin (500 mg/day): prospective, open-label, randomized, controlled, multicenter, non-inferiority clinical trial. International Urology and Nephrology (2017).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.