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Urinary tract infections are considered severe and “complicated” if they carry a high risk of complications.

A urinary tract infection (UTI), which causes pain and discomfort, is something you’d want to cure as soon as possible when experiencing it. Often, simple UTIs can be treated with short-term antibiotics. However, some urinary tract infections are more severe and complicated, requiring different and more complex treatment regimens.

Types of Urinary Tract Infections

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Most urinary tract infections are simple or uncomplicated. On the other hand, there are also complicated UTIs that are harder to treat or carry a higher risk of complications. This condition is diagnosed based on an individual’s risk factors and the characteristics of the infection itself.

A urinary tract infection is considered uncomplicated if it occurs in a healthy person with a normal urinary tract. In contrast, complicated UTIs occur in an abnormal urinary tract or when most antibiotics cannot treat the bacteria causing the infection.


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Additionally, UTIs in women are considered uncomplicated, whereas those occurring in men and children are classified as complicated.

1. Uncomplicated Urinary Tract Infection

To be classified as uncomplicated, a UTI must occur in a woman and not be accompanied by:

Moreover, uncomplicated UTIs must be limited to the lower urinary tract, which includes the bladder and urethra—the tube that carries urine from the bladder to the outside of the body.

Finally, a UTI is considered uncomplicated if caused by common bacteria responsible for UTIs, which naturally exist in the human digestive system and around the genital area.

2. Severe (Complicated) Urinary Tract Infection

A urinary tract infection is considered severe or complicated if it occurs in:

A urinary tract infection is also considered complicated if the infection:

Causes of Urinary Tract Infection

Most UTIs (80 percent) are caused by the bacteria Escherichia coli, commonly known as E. coli. This bacterium normally resides in the human digestive tract and around the genital area. Other types of bacteria that can cause UTIs include:

The above bacteria and several others can cause complicated UTIs. However, complicated UTIs are more often caused by bacteria that are resistant to drugs.

Differences in Symptoms Between Simple and Severe Urinary Tract Infections

Typical symptoms of uncomplicated UTIs include:

Symptoms of complicated UTIs include the above symptoms of uncomplicated UTIs, along with one of the following additional symptoms:

If you experience any of these symptoms, contact your doctor immediately to ensure you receive the appropriate treatment.

Risk Factors for Urinary Tract Infection

Several factors can increase the likelihood of developing a UTI, including:

Diagnosis of Urinary Tract Infections

Urinary tract infections can be easily confirmed through a complete urinalysis. Urine is examined under a microscope to look for bacteria or white blood cells, which indicate the presence of an infection. If necessary, the doctor will request a urine culture. This test aims to detect and identify bacteria or fungi that may be causing the UTI.

If you find blood in your urine, contact your doctor immediately. Blood in the urine can be caused by a UTI, but it could also result from other issues in the urinary tract. Additionally, visit your doctor promptly if you have a fever along with UTI symptoms or if your symptoms persist despite treatment. Further testing, such as ultrasound or a CT scan, may be needed to assess the entire urinary tract.

Differences in Treatment Between Simple and Severe Urinary Tract Infections

In general, simple UTIs can be treated with the appropriate short-term antibiotics, typically for about 3-5 days. However, some infections may require longer treatment. Pain and urgency to urinate often subside after taking a few doses of antibiotics, but you must complete the full course of antibiotics as prescribed to ensure all the bacteria are eliminated. If a UTI is not treated properly, it can recur. It is also important to drink plenty of water during UTI treatment to help flush the bacteria from the urinary tract.

Postmenopausal women with UTIs may be prescribed topical estrogen hormone replacement, administered vaginally. Before using it, discuss with your doctor to ensure this hormone replacement therapy is safe for you.

Common antibiotics used to treat uncomplicated UTIs include:

The choice of antibiotic for treatment depends on the most common bacteria in the community, any allergies to specific antibiotics, and previous UTI history.

If the UTI becomes complicated, such as in the case of a kidney infection, longer antibiotic treatment is necessary. Sometimes, intravenous (IV) antibiotic therapy is required in the hospital, followed by oral antibiotics for two weeks at home.

Antibiotics used to treat complicated UTIs are generally stronger and include:

Post-Treatment for Urinary Tract Infection

Symptoms of a simple UTI usually improve within a few days of starting antibiotics. If all UTI symptoms resolve after completing the antibiotic course, a follow-up urine culture is not necessary to prove the infection is gone.

However, in complicated UTIs, a post-treatment urine culture is needed to confirm the infection has been eradicated. If symptoms do not resolve after antibiotic treatment, longer antibiotic therapy, a different type of antibiotic, or a different method of administration may be necessary.

Approximately 20-40 percent of women who experience a UTI will have a recurrence. Men are less likely to develop UTIs, but a man who has had a UTI is more likely to experience it again because the bacteria tend to hide in the prostate gland.

If you frequently suffer from UTIs, defined as three or more in a year, consult your doctor. Additional tests may be needed, such as evaluating bladder emptying function. If UTIs are frequent, long-term low-dose antibiotics or antibiotics taken after sexual intercourse may be required.

Ways to Prevent Urinary Tract Infections

Urinary tract infections are one of the preventable conditions. Here are some ways to reduce the risk:

Conclusion

Most urinary tract infections (UTIs) are simple, uncomplicated, and easily treated with antibiotics. However, it is important to recognize the signs and symptoms of complicated UTIs, as these types are at risk of treatment failure and can lead to more severe complications.

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