quick reference
2025 IDSA Guidelines: Executive Summary 7_14_25
Uncomplicated UTI
- Dysuria, urgency, frequency, hesitancy, suprapubic pain
- No systemic symptoms (fever, chills)
- No urinary symptoms for 4 weeks prior to current episode
Complicated UTI
Urosepsis
- Sepsis from urinary tract infection
clinical features
Uncomplicated UTI
- A clinical syndrome characterized by local bladder signs and symptoms such as dysuria, urgency, frequency, and suprapubic pain.
- Uncomplicated UTI is presumed to be confined to the bladder and is defined by absence of signs or symptoms which suggest an infection extending beyond the bladder:
- No fever, unless explained by a non-UTI cause
- No other signs or symptoms of systemic illness (including chills, rigors, or unstable vital signs), unless explained by a non-UTI cause
- No flank pain
- No costovertebral angle tenderness
Complicated UTI
- Complicated UTI is accompanied by symptoms which suggest an infection extending beyond the bladder, including:
- Fever
- Other signs or symptoms of systemic illness (including chills, rigors, or hemodynamic instability)
- Flank pain
- Costovertebral angle tenderness
- Pyelonephritis is encompassed in complicated UTI.
- UTI with systemic symptoms associated with transurethral, suprapubic, or intermittent catheterization is encompassed in complicated UTI.
Urosepsis
- SIRS + cUTI as suspected source of infection +/- shock
diagnosis
Uncomplicated UTI
- UA +/- culture
Complicated UTI
- CBC
- CMP
- UA + culture
- +/- CT A/P with IV contrast
Urosepsis
- CBC
- CMP
- UA + culture
- Blood Cultures
- Lactate
- CT A/P with IV contrast
treatment
Uncomplicated UTI
Outpatient: Nitrofurantoin, Bactrim, Keflex
Complicated UTI
Outpatient: Cipro, Bactrim, 3rd gen cephalosporin +/- 1st dose IV in ED
Inpatient: See guidelines
Urosepsis
w/ shock: tailor Abx to >90% susceptibility per local antibiogram
w/o shock: tailor Abx to >80% susceptibility per local antibiogram