Urinary tract infection, pyelonephritis and urosepsis
Pyelonephritis and urosepsis after the 2025 Therapeutic Guidelines and IDSA updates, the obstructed infected kidney, prostatitis, catheter-associated infection, asymptomatic bacteriuria in older people, and preventing recurrent UTI.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- UTI runs from cystitis to septic shock. This note covers pyelonephritis, urosepsis, men, catheters, older people and recurrence. Cystitis and the approach to dysuria are in the dysuria note.
- Therapeutic Guidelines (March 2025): oral therapy for pyelonephritis in non-pregnant adults without sepsis who can take tablets. IV amoxicillin was removed from the gentamicin combination except in pregnancy.
- IDSA 2025 supports 7 days for most complicated UTI that responds, including with Gram-negative bacteraemia.
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Sources
- Therapeutic Guidelines: Antibiotic. Urinary tract infections in adultsAU/NZTherapeutic Guidelines Limited (eTG complete), Revised March 2025 (oral therapy for pyelonephritis without sepsis; IV amoxicillin removed from non-pregnant regimens)
- Complicated urinary tract infections (cUTI) guidelineInfectious Diseases Society of America, 2025
- Nicolle LE et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis 2019;68:e83-110Infectious Diseases Society of America, 2019
- EAU Guidelines on Urological InfectionsEuropean Association of Urology, 2026
- Harding C et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women (ALTAR). BMJ 2022;376:e068229BMJ, 2022
- Hooton TM et al. Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections. JAMA Intern Med 2018;178:1509-15JAMA Internal Medicine, 2018
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback