DEFINITIONS

Cystitis (Lower UTI)

• Dysuria
• Suprapubic pain
• Frequent urination, urgency, and incontinence
• Occasionally: hematuria, cloudy urine, or foul-smelling urine

Pyelonephritis (Upper UTI; ascending UTI that has reached the level of the renal pelvis)

• More severe and systemic presentation than cystitis.
• Cystitis symptoms above plus some of the following:
  • Febrile (>38)
  • Chills
  • Flank pain, costovertebral angle tenderness
  • N/V
  • Elevated WBC count. 

Complicated

• Male
• Urinary catheter within last 48 hours
• Stent, nephrostomy tube, or urinary diversion
• Structural abnormality, functional abnormality, presence of foreign body
• Recent urinary instrumentation
• Obstruction (e.g., stone)
• Compromised host (immunosuppression or diabetes)
• Renal failure, insufficiency, or renal transplant
• Urinary retention
• Pregnancy (can also be asymptomatic bacteriuria)
• Hospital-acquired infection
• Symptoms lasting 7 or more days before seeking care

Uncomplicated: none of the above are present


​TREATMENT OVERVIEW​