A new clinical guideline outlines a tiered treatment strategy for complicated urinary tract infections (cUTIs), emphasizing the illness's severity and risk of antibiotic resistance. The guideline recommends empiric antibiotic selection based on whether patients have sepsis, with specific recommendations for various generations of cephalosporins and other agents. A structured four-step framework for treatment includes assessing severity, evaluating drug safety, and consulting local antibiogram data. Recommendations also focus on de-escalating broad-spectrum antibiotics to targeted agents based on culture results. Nitrofurantoin and oral fosfomycin are not suggested due to poor effectiveness in cUTIs.

Source: IDSA