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[Urosepsis].

Mathias W Pletz1,2, Sebastian Weis1,2,3, Christina Forstner1,4

  • 1Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|February 15, 2018
PubMed
Summary

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This summary is machine-generated.

Prompt antibiotic therapy is crucial for severe urinary tract infections (urosepsis). Early diagnosis and broad-spectrum antibiotics, followed by de-escalation, improve patient outcomes.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Urology

Background:

  • Urosepsis, a severe condition from urinary tract infections, leads to organ failure.
  • Prompt initiation of empirical antibiotic therapy is vital, ideally within one hour of diagnosis.
  • Gram-negative pathogens are common causes, with a rising incidence of extended-spectrum beta-lactamase (ESBL) producing bacteria.

Purpose of the Study:

  • To outline the critical management steps for urosepsis.
  • To highlight the importance of early diagnosis and intervention.
  • To discuss current antibiotic strategies for urosepsis.

Main Methods:

  • Review of current clinical guidelines and literature on urosepsis management.
  • Emphasis on diagnostic procedures including urine and blood cultures prior to antibiotic administration.
Keywords:
Antibiotic therapySepsisStaphylococcus aureusUrinary tract infectionsUrogenital system

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  • Discussion of imaging for early detection of complications like obstruction or abscesses.

    • Main Results:

    • Empirical antibiotic therapy should be broad-spectrum, typically a beta-lactam agent.
    • Piperacillin/tazobactam, carbapenems, and cephalosporin/beta-lactamase inhibitor combinations are recommended as monotherapy.
    • Cephalosporins may require combination with aminoglycosides or fluoroquinolones, with a plan for de-escalation to monotherapy.

    Conclusions:

    • Timely and appropriate antibiotic selection is key in managing urosepsis.
    • Early diagnostics and source control are essential for severe cases.
    • Monitoring for and addressing the rise of resistant pathogens like ESBL-producing bacteria is crucial.