Staff report that a resident is exhibiting signs and symptoms of a urinary tract infection (UTI). This resident has had multiple UTIs and recently completed a course of antibiotics. It is likely this resident has what is referred to as a complicated bladder infection. Complicated UTI treatment is often more challenging. These infections may involve antibiotic-resistant bacteria and require more intensive care than an uncomplicated infection.

Complicated bladder infections often present with the familiar signs of a UTI. They may also include symptoms that suggest a more serious condition. Watch for frequent urination, painful urination, cloudy or foul-smelling urine, lower abdominal pain, fever and chills, nausea and vomiting, flank pain, and confusion or changes in mental status. While confusion alone should not be used to diagnose a UTI, it should always prompt a thorough assessment to identify the underlying cause.

Treatment for complicated bladder infections has traditionally been more intensive. Some residents require hospitalization and intravenous antibiotics. Fortunately, there is encouraging news. The U.S. Food and Drug Administration recently approved the first oral carbapenem therapy for complicated urinary tract infections. According to the FDA announcement, this new antibiotic targets a broad range of multidrug-resistant organisms (MDROs). These organisms are commonly seen in older adults.

This approval provides another option for complicated UTI treatment. It may reduce the need for intravenous medications or inpatient stays for appropriate residents. If you are caring for a resident with a complicated UTI, talk with the attending physician and your pharmacy provider. They can help determine whether this newly approved therapy is an appropriate option.

Stay well and stay informed!