Complicated UTI: 2025 IDSA Guidelines

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The Infectious Diseases Society of America (IDSA) developed the 2025 Clinical Practice Guideline to address the rising global burden and increasing antibiotic resistance associated with complicated urinary tract infections (cUTI). These updated standards introduce a new classification system that defines a UTI as complicated if the infection spreads beyond the bladder, regardless of the patient's sex or underlying health conditions. By moving away from older definitions that focused on anatomy, the authors provide a more practical framework for emergency and hospital clinicians to manage systemic illnesses like pyelonephritis and catheter-associated infections. The guidelines were constructed using the GRADE methodology, incorporating systematic reviews of recent clinical trials and direct input from patient representatives. This comprehensive update specifically focuses on empiric antibiotic selection, the transition from intravenous to oral therapy, and the necessary duration of treatment. Overall, the document serves as a modern evidence-based resource to optimize care for adults facing severe or escalating urinary infections.