Patient assessment in urinary tract infections: symptoms, risk factors and antibiotic treatment options

Urinary tract infections (UTI) may present with rather distinct clinical pictures. However, being caused by invasion of billions of living organisms a UTI may progress into severe conditions leading to loss of kidney function or even death of the patient. Young urologists used to think that a UTI may be stopped at any time point by effective antibiotics. During the last decade an increasing number of signs have told us that UTIs are not what they used to be. Antibiotics have been prescribed so extensively that bacteria have developed resistance mechanisms to more and more drugs. Recently omni-resistant urinary tract pathogens were reported. The European Section for Infections in Urology (ESIU) has introduced a new concept of severity assessment of UTI. The assessment is based on three pillars; clinical presentation, patient risk factors and availability of effective antibiotics. This article presents the new concept of classification and gives practical advices on the use of antibiotics in urology.