Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
Clinical Practice Guidelines by Infectious Diseases Society of America (IDSA): 2025 Guidelines on Management and Treatment of Complicated Urinary Tract Infections--Duration of Antibiotics for Complicated UTI.
СтатьяКлинические рекомендацииПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Trautner Barbara W, Cortés-Penfield Nicolás W, Gupta Kalpana, Hirsch Elizabeth B, Horstman Molly, Moran Gregory J, Colgan Richard, O'Horo John C, Ashraf Muhammad S, Connolly Shannon, Drekonja Dimitri, Grigoryan Larissa, Huttner Angela, Lazenby Gweneth B, Nicolle Lindsay, Schaeffer Anthony, Yawetz Sigal, Lavergne Valéry
Аннотация
BACKGROUND: These recommendations provide guidance on the optimal duration of antibiotics in patients with complicated urinary tract infection (cUTI), especially in presence of associated Gram-negative bacteremia.
METHODS: The panel's recommendations are based upon evidence derived from systematic literature reviews which focused on comparative benefits and harms of shorter (5-7 days) vs prolonged (10-14 days) duration of antibiotics, including publications since 2000. These recommendations adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.
RESULTS: The guidelines panel suggests that patients with cUTI who are improving on effective therapy can be treated with shorter duration of antimicrobials (either 5-7 days of a fluoroquinolone or 7 days of a non-fluoroquinolone) rather than longer courses of antibiotics, regardless of the presence of associated Gram-negative bacteremia. An effective antimicrobial agent achieves therapeutic levels in the urine and relevant tissue and is active against the causative pathogen. However, men with febrile UTI in whom acute bacterial prostatitis is suspected may benefit from a longer treatment duration (10-14 days), and a short courses of oral beta lactams may require higher doses for efficacy.
CONCLUSIONS: Shorter durations of antibiotics for cUTI provide similar efficacy as longer courses, except in men with febrile UTI in whom acute bacterial prostatitis is suspected. This recommendation places a high value on antibiotic stewardship considerations as well as reducing the burden of antimicrobial administration from a healthcare perspective and reducing the burden of taking antibiotics from a patient perspective.
METHODS: The panel's recommendations are based upon evidence derived from systematic literature reviews which focused on comparative benefits and harms of shorter (5-7 days) vs prolonged (10-14 days) duration of antibiotics, including publications since 2000. These recommendations adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.
RESULTS: The guidelines panel suggests that patients with cUTI who are improving on effective therapy can be treated with shorter duration of antimicrobials (either 5-7 days of a fluoroquinolone or 7 days of a non-fluoroquinolone) rather than longer courses of antibiotics, regardless of the presence of associated Gram-negative bacteremia. An effective antimicrobial agent achieves therapeutic levels in the urine and relevant tissue and is active against the causative pathogen. However, men with febrile UTI in whom acute bacterial prostatitis is suspected may benefit from a longer treatment duration (10-14 days), and a short courses of oral beta lactams may require higher doses for efficacy.
CONCLUSIONS: Shorter durations of antibiotics for cUTI provide similar efficacy as longer courses, except in men with febrile UTI in whom acute bacterial prostatitis is suspected. This recommendation places a high value on antibiotic stewardship considerations as well as reducing the burden of antimicrobial administration from a healthcare perspective and reducing the burden of taking antibiotics from a patient perspective.