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Guidelines
Pathogens
Antimicrobials
Most likely pathogens and suggested antimicrobial therapy
Definition of uncomplicated UTI
Cystitis or pyelonephritis in a generally healthy, nonpregnant female with normal urinary tract anatomy and no features of complicated infection
Complicated features
Anatomical abnormality of the urinary tract including obstruction (i.e. stone), ileal conduit/urinary diversion, and instrumentation/foreign body (i.e. stent, nephrostomy tube).
Immunosuppressed patients (this includes poorly controlled diabetes).
The absence of pyuria strongly argues against UTI
Urine culture recommended due to increasing prevalence of resistance, and blood culture for patients with febrile UTI and features of upper tract infection
Additional Investigations:
Pregnancy test.
Pelvic exam and STI testing when appropriate.
In general radiology not required - the diagnosis of pyelonephritis is clinical.
Imaging appropriate if suspicion of complication or obstruction.
