Oral antibiotics are as effective as parenteral therapy in severe urinary tract infection

Clinical question: 
What is the most effective mode of administration for antibiotic therapy in severe urinary tract infection (UTI)?
Bottom line: 
Therapeutic success does not depend on the mode of antibiotic administration. Compared to intramuscular (IM) or intravenous (IV) antibiotics, oral therapy is not shown to be less effective in treating severe UTI and preventing long-term damage in adults and children. Severe UTI is the clinical syndrome of fever, bacteriuria, pyuria and symptoms of UTI (flank pain and dysuria). Using oral antibiotics could reduce costs and inconvenience for patients.
Caveat: 
Most included studies were small, ranging from 20 to 387 participants, with over half involving less than 100 patients. Due to different outcome parameters, such as when a cure was deemed to have occurred, few studies were available for combination in a meta-analysis.
Context: 
Severe UTI is a common infection in adults and children, and can lead to serious complications, such as hypertension and renal failure.
Review CD#: 
CD003237
PEARLS No: 
57
Date: 
April, 2008
Authored by: 
Brian R McAvoy