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Urinary tract infection management – do the guidelines agree?

Lookup NU author(s): Professor Christopher HardingORCiD


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© 2018, © British Association of Urological Surgeons 2018. Urinary tract infection (UTI) is defined as the inflammatory response of the urothelium to bacterial invasion. UTI in adults is one of the most prevalent infectious diseases worldwide with a substantial financial burden on society. There is mounting concern surrounding the ongoing development of microbial resistance. In addition, the increasing resistance of organisms to broad-spectrum antibiotics is worrying. There is a continuing drive for antibiotic stewardship and more prudent prescribing of antimicrobial agents. There is currently no national UK guideline on the management of UTI in adults but the EAU, AUA and SIGN all have their separate recommendations. In this review, we discuss the existing guideline recommendations particularly relating to lower UTIs (cystitis and epididymo-orchitis), upper UTIs (pyelonephritis) and catheter-associated infections (due to their large healthcare burden). The aims are to identify common recommendations and assess how they may apply for the UK setting. This review has highlighted considerable differences in practice recommendations between the major UK, European and American guidelines. Discrepancy exists in the choice of antibiotics and for some types of infection, whether or not any guidance for treatment is offered. Antibiotic avoidance and prudent antibiotic prescribing will be key components of future strategies in reducing antimicrobial resistance.

Publication metadata

Author(s): Moon A, Veeratterapillay R, Garthwaite M, Harding C

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Urology

Year: 2018

Volume: 11

Issue: 2

Pages: 81-87

Print publication date: 01/03/2018

Online publication date: 13/03/2018

Acceptance date: 01/11/2016

ISSN (print): 2051-4158

ISSN (electronic): 2051-4166

Publisher: SAGE Publications Ltd


DOI: 10.1177/2051415816681248


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