The patient presenting with recalcitrant urinary tract infections

In this chapter, recalcitrant urinary tract infection is defined as frequent, recurrent symptomatic infection which is not adequately managed with standard therapeutic approaches. The discussion addresses only adult patients. Urinary infection is considered uncomplicated when it occurs in women with an otherwise normal genitourinary tract and may include the less frequently encountered acute non-obstructive and non-refluxing pyelonephritis. Complicated urinary infection occurs in a patient with functional or structural abnormalities of the genitourinary tract. A wide range of abnormalities may be associated with complicated urinary infection, but the consistent defect is failure of voiding to effectively clear organisms from the urinary tract. Recalcitrant urinary infection may occur in either of these groups, although it is more common with complicated urinary infection. Asymptomatic bacteriuria is bacteria in the urine with no signs or symptoms referable to infection.