Publication Date: September 2022 (Volume 1, Number 6)
CME Credits: 4 AMA PRA Category 1 Credits™. CME expires 09/01/2025.
Specialty CME: Included as part of the 4 credits, this CME activity is eligible for 3 Pharmacology CME credits, subject to your state and institutional requirements.
Editor-in-Chief & Update Author
Urgent Care Peer Reviewer
Pharmacology Peer Reviewer
Original Peer Reviewers
How would you manage these patients? Subscribe for evidence-based best practices and to discover the outcomes.
Urinary tract infections (UTIs) represent a heterogeneous group of disorders involving infection of all or part of the urinary tract. In the United States, UTIs result in more than 10 million outpatient healthcare encounters and approximately 1 million emergency department (ED) visits each year.1 Females are much more commonly affected than males. While the diagnosis and treatment of UTIs may seem like routine tasks for urgent care (UC) clinicians, effective management of the full spectrum of urinary tract conditions and their mimics presents a variety of challenges. Proper management of UTIs will decrease treatment failures, bouncebacks, and complications. By being familiar with atypical presentations and knowing when more extensive workup is indicated, clinicians can optimize outcomes and minimize errors in the management of UTI.
UTIs are divided into those involving the lower tract and those involving the upper tract. Lower tract infection is confined primarily to the urinary bladder and is termed cystitis. Infection of the upper urinary tract is termed pyelonephritis and indicates involvement of the kidney and ureter. Pyelonephritis is characteristically more severe than cystitis, and patients with pyelonephritis frequently have systemic symptoms and appear more ill.
UTIs are also classified as uncomplicated versus complicated. This classification is not specifically anatomic or physiologic, but more generally attempts to discern which patients are most likely to recover uneventfully with therapy (uncomplicated) versus patients who are at an increased risk of treatment failure (complicated). Patient comorbidities are the primary determinants of whether a UTI is complicated versus uncomplicated.2
The frequency and relatively benign course of most UTIs may lull UC clinicians into the false perception that these are always simple cases. While most UTIs are straightforward to diagnose, patient comorbidities, local bacterial susceptibility patterns, and available antibiotic choices and costs must be considered to ensure an optimal outcome.