345 Ch 344. Urinary Tract Infection (UTI), Pyelonephritis, and Prostatitis

UTI 範圍：(1) acute uncomplicated cystitis (women, no anatomical abnormality)；(2) complicated UTI (men, pregnancy, diabetics, immunocompromised, anatomic, instrumentation)；(3) acute pyelonephritis (upper urinary tract infection)；(4) recurrent UTI；(5) asymptomatic bacteriuria (treat only in pregnancy + pre-urologic procedure)；(6) catheter-associated UTI (CAUTI)；(7) prostatitis (acute, chronic bacterial, CPPS/chronic pelvic pain)；common pathogens：E. coli (75-95% uncomplicated) > Klebsiella > Proteus (urease, struvite) > Enterococcus > S. saprophyticus (young women) > Pseudomonas (complicated)；uncomplicated cystitis：nitrofurantoin 100 BID × 5 d or TMP-SMX (if resistance < 20%) or fosfomycin single dose；pyelonephritis outpatient：fluoroquinolone (ciprofloxacin) × 5-7 d；inpatient：IV ceftriaxone or fluoroquinolone；MDR uropathogens (ESBL, CRE) increasing — 2024 cefiderocol, ceftazidime-avibactam, meropenem-vaborbactam for select；recurrent UTI prevention：postcoital prophylaxis, methenamine, cranberry (modest), vaginal estrogen (postmenopausal), D-mannose; vaccines emerging (Uromune)。