From the Research
For a complicated urinary tract infection (UTI), the most effective treatment option is cefepime + enmetazobactam, which has been shown to have a higher relative risk of efficacy compared to carbapenems, according to a recent systematic literature review and network meta-analysis 1.
Treatment Options
The treatment of complicated UTIs typically involves antibiotics for 7-14 days, with costs varying based on medication and insurance coverage.
- First-line options include nitrofurantoin (100mg twice daily for 7 days) at $30-60, or fosfomycin (3g single dose) at $50-100, as recommended by a recent study on the treatment of urinary tract infections in the era of antimicrobial resistance 2.
- For more severe cases, especially with resistant bacteria, options include cefepime + enmetazobactam, which has been shown to be effective against multidrug-resistant organisms (MDRO) linked to cUTI 1.
- Hospitalization may be necessary for pyelonephritis or systemic symptoms, adding significant costs ($2,000-10,000).
Additional Expenses
Additional expenses include:
- Urine cultures ($30-100)
- Follow-up visits ($100-200)
- Symptom management medications
Importance of Thorough Treatment
Complicated UTIs require thorough treatment due to risk factors like anatomical abnormalities, immunosuppression, pregnancy, or resistant organisms.
- Complete the full antibiotic course even if symptoms improve
- Drink plenty of fluids
- Follow up with your healthcare provider to ensure resolution and prevent recurrence, as emphasized by a recent review on complicated urinary tract infections 3.
Recent Evidence
A recent study on the evaluation of oral amoxicillin/clavulanate for urinary tract infections caused by ceftriaxone non-susceptible Enterobacterales found that amoxicillin-clavulanate may be a useful alternative therapy for the treatment of ceftriaxone non-susceptible Enterobacterales UTIs 4. However, the most recent and highest quality study 1 suggests that cefepime + enmetazobactam is a more effective treatment option for complicated UTIs.