Nursing Diagnosis for UTI: 5 Sample Care Plans, Interventions & Prevention

Choosing the right nursing diagnosis for UTI — and building a clean care plan around it — is one of the most common assignments in nursing school, and one of the most common bedside scenarios you’ll meet in clinicals. Urinary tract infections are among the most frequent bacterial infections out there: roughly 40% of women will have one in their lifetime, and about 10% have one every year.¹

Here’s the good news: once you understand the pattern — how a UTI starts, what it does to the bladder, and what your priorities are — care planning gets a lot less intimidating. This guide covers the full nursing diagnosis for UTI workflow: assessment, diagnostics, five sample NANDA-I care plans (with goals, interventions, rationales, and evaluation), the medications you’ll see, and the prevention teaching that keeps patients from coming back.

Scope note. This guide is for nursing education. It isn’t a substitute for your facility’s policies, your provider’s orders, or your instructor’s guidance. Always follow institutional protocols and current provider orders for real patients.

Quick answer. The most common nursing diagnoses for a UTI are Impaired Urinary Elimination, Acute Pain, Risk for Infection, Hyperthermia, and Deficient Knowledge. Pick the one that matches your patient’s strongest data — burning and frequency point to impaired elimination; suprapubic pain points to acute pain; fever points to hyperthermia.

At a glance: matching findings to the priority diagnosis

Common mistakes to avoid. (1) Listing phenazopyridine (AZO) as an antibiotic — it only numbs symptoms. (2) Writing “avoid all NSAIDs” — NSAIDs are fine with an antibiotic. (3) Treating cloudy or smelly urine alone as proof of infection. (4) Forgetting that confusion may be the only UTI sign in an older adult. (5) Using nitrofurantoin for a kidney infection — it doesn’t reach the kidney tissue.

Table of contents

• What is a UTI? Cystitis vs. pyelonephritis
• Causes and risk factors
• Signs and symptoms
• Nursing assessment
• Diagnostic and lab studies
• UTI nursing diagnoses (how to choose)
• Nursing goals and expected outcomes
• Nursing interventions and rationales
• Nursing diagnosis for UTI: 5 sample care plans
• Pharmacologic management
• When a UTI moves upstream: pyelonephritis
• Escalation red flags (urosepsis)
• Discharge and patient teaching
• Charting it: FDAR example
• NCLEX practice question
• FAQs
• Related resources
• References

What is a UTI? Cystitis vs. pyelonephritis

A urinary tract infection is exactly what it sounds like — an infection somewhere in the urinary tract. What matters clinically is where:

• Cystitis is a lower-tract infection, confined to the bladder. It usually shows up without fever or systemic illness.¹
• Pyelonephritis is an upper-tract infection involving the kidney. This one brings fever, flank pain, and feeling genuinely sick.¹

There’s a second split you’ll be tested on:

• Uncomplicated UTI happens in an otherwise healthy, non-pregnant person with a normal urinary tract.¹
• Complicated UTI comes with something that raises the stakes — an indwelling catheter, obstruction, pregnancy, poorly controlled diabetes, immunocompromise, or male sex.¹

Don’t mix these up. A UTI in a man is automatically classified as complicated. Men rarely get UTIs without an underlying reason (like prostate enlargement or instrumentation), so they typically need a longer course and a closer look.¹

Causes and risk factors

Most UTIs are bacterial, and the leading culprit by far is Escherichia coli (E. coli) — it causes roughly 65–80% of community-acquired cases.^1,2

Here’s a point a lot of students get wrong: E. coli isn’t “food-poisoning bacteria” that somehow lands in the bladder. E. coli normally lives in your gut. A UTI happens when those gut and perineal organisms ascend the urethra into the bladder.¹ Same name, completely different route from foodborne illness.

Other common uropathogens include Staphylococcus saprophyticus (classic in young, sexually active women), Klebsiella species, Proteus species (linked to urease and struvite stones), and Enterococcus.¹

Risk factors that raise UTI likelihood:

• Female anatomy — a shorter urethra positioned closer to the anus means bacteria travel a shorter distance.¹
• Sexual activity, which can mechanically introduce periurethral flora.¹
• Indwelling urinary catheters — and the longer the catheter stays in, the higher the risk.⁶
• Postmenopausal estrogen loss, which disrupts the protective, acidic vaginal environment.¹
• Diabetes mellitus, especially when poorly controlled.¹
• Bladder outlet obstruction or BPH, which causes urinary stasis and incomplete emptying.¹
• Older age and functional impairment.¹

Catheters deserve a callout. Per the CDC, duration of catheterization is the single biggest CAUTI risk factor, with each catheter-day raising risk by about 3–7%.⁶ The nursing takeaway: question every catheter, every day.

Signs and symptoms

UTI symptoms cluster by location. For exams and assessment, sort them into subjective (what the patient reports) and objective (what you observe or measure).

Patients with simple cystitis usually don’t have fever, chills, nausea, or flank pain. When those show up, think upper tract — pyelonephritis.¹

High-yield flag — older adults. A UTI in an elderly patient may show up without the classic burning or fever. Instead, the first sign can be new confusion or delirium, drowsiness, falls, or functional decline.⁵ But not every episode of confusion is a UTI, and guidance warns against treating asymptomatic bacteriuria — look for the full picture, not just a positive dipstick.⁵

Nursing assessment

A focused nursing diagnosis for UTI starts with a clean assessment. Gather both the story and the data.

Health history

• Onset and pattern of urinary symptoms (burning, frequency, urgency, hesitancy)
• Pain — location, quality, and whether it’s suprapubic (bladder) or flank (kidney)
• Fever, chills, nausea, or vomiting
• Recent catheter use, instrumentation, or sexual activity
• History of recurrent UTIs (about 30% of women have a recurrence within 6 months of an initial infection)¹
• Comorbidities: diabetes, immunosuppression, pregnancy, BPH

Physical assessment

• Vital signs — watch for fever and any early signs of sepsis
• Suprapubic tenderness on palpation
• Costovertebral angle (CVA) tenderness — a red flag for pyelonephritis¹
• Bladder distention; assess for urinary retention and incomplete emptying
• Characteristics of the urine: color, clarity, odor

A quick note on technique: assess for retention by checking for bladder distention (a bladder scanner is more reliable than palpation alone when available). Follow your facility’s policy on bladder scanning and catheterization, and link your findings to the patient’s urinary retention risk where relevant.

Diagnostic and lab studies

This is where a lot of care plans get vague. Know what each test actually tells you.

Urinalysis (dipstick)

• Nitrites — formed when bacteria like E. coli convert urinary nitrate to nitrite. They’re highly specific but not sensitive. A positive nitrite strongly suggests bacteria, but a negative nitrite does not rule out a UTI — some organisms don’t reliably produce it.¹
• Leukocyte esterase (LE) — a marker of pyuria (WBCs). More sensitive but less specific than nitrites.¹
• Pyuria — more than 10 WBCs per high-power field is generally abnormal in a symptomatic patient.¹

Urine culture and sensitivity

The diagnostic standard — it identifies the organism and guides antibiotic choice. The classic threshold is ≥10⁵ (100,000) CFU/mL, but in a symptomatic patient, ≥10³ (1,000) CFU/mL of a uropathogen can mean true infection. About 20–40% of women with a UTI have ≤10⁴ CFU/mL, so a lower count doesn’t exclude infection when symptoms are present.¹

Pattern breaker. Cloudy or smelly urine is not proof of a UTI. Don’t diagnose by eyeball — culture is what confirms it.¹

Imaging (CT urography or ultrasound) isn’t routine for simple cystitis. Reserve it for complicated infections, suspected pyelonephritis that isn’t improving, recurrent infection, or suspicion of obstruction or stones.¹

UTI nursing diagnoses (how to choose)

A UTI affects comfort, urinary function, infection risk, temperature regulation, and the patient’s understanding of how to prevent the next one. That’s why several nursing diagnoses can apply at once. Your job is to prioritize based on the patient’s strongest data.

These five NANDA-I labels — the nursing diagnoses, or “dx,” you’ll reach for most — cover the vast majority of UTI care plans (current 2024–2026, 13th edition):¹⁴

1. Impaired Urinary Elimination — related to bladder irritation and inflammation
2. Acute Pain — related to inflammation of the urinary tract
3. Risk for Infection (or spread of infection) — related to urinary stasis, catheter use, or inadequate hygiene
4. Hyperthermia — related to the inflammatory/infectious process
5. Deficient Knowledge — related to prevention and the treatment regimen

NANDA-I reminder. Confirm exact label wording, codes, and defining characteristics against the official NANDA-I 2024–2026 (13th ed.) text before submitting a graded care plan — labels are periodically revised.¹⁴

Nursing goals and expected outcomes

Every solid nursing diagnosis for UTI needs measurable, patient-centered outcomes. Aim for goals you can actually evaluate by the end of a shift or a treatment course:

• The patient reports decreased pain and urinary discomfort (e.g., pain ≤2/10).
• Urine returns to clear, with normal color and odor.
• The patient maintains adequate output (generally ≥30 mL/hr or per provider parameters) without retention.
• Temperature returns to and stays within normal limits.
• No signs of systemic infection (fever, chills, flank pain) develop or persist.
• The patient verbalizes understanding of prevention strategies before discharge.

Nursing interventions and rationales

Good nursing interventions always pair the action with the why. Here’s the high-yield monitoring and care set for a UTI:

• Monitor for worsening infection — rising fever, increasing pain, tachycardia, hypotension, or falling urine output. Why: these signal progression toward pyelonephritis or urosepsis.
• Track response to treatment — improving urine output, decreasing WBCs, resolving fever and pain. Why: confirms the antibiotic is working.
• Encourage fluids (about 2–3 L/day unless contraindicated). Why: increased intake promotes flushing; a randomized trial found adding 1.5 L of water/day cut recurrent cystitis episodes nearly in half.¹² Always check fluid restrictions first.
• Promote complete, regular voiding (about every 2–3 hours). Why: urinary stasis lets bacteria multiply.¹
• Assess for bladder distention/retention. Why: retention worsens stasis and infection risk.
• Give antibiotics as ordered, on time. Why: maintaining therapeutic levels clears the organism.³
• Practice meticulous catheter care, and advocate for early removal. Why: every catheter-day raises CAUTI risk; early removal is the most effective prevention.⁶

Nursing diagnosis for UTI: 5 sample care plans

Below are five build-out nursing diagnosis for UTI care plans (NCPs) you can adapt. Each follows the standard format — diagnosis statement, goals, interventions with rationales, and evaluation. Match the diagnosis to your patient’s actual data; you won’t use all five on every patient.

Care plan 1 — Impaired Urinary Elimination

A care plan built around elimination fits the patient whose main problem is urgency, frequency, and dysuria.

Diagnosis. Impaired Urinary Elimination related to bladder irritation and inflammation, as evidenced by urgency, frequency, hesitancy, dysuria, and cloudy urine.¹⁴

• Goal: The patient returns to their usual voiding pattern within 48–72 hours.
• Goal: The patient voids without urgency, hesitancy, or burning by discharge; urine is clear.

Evaluation: voiding pattern normalizes; urgency/frequency resolve; urine clears; no retention.

Care plan 2 — Acute Pain

Diagnosis. Acute Pain related to inflammation of the urinary tract, as evidenced by dysuria, suprapubic discomfort, and/or lower-back pain.¹⁴

• Goal: The patient reports pain reduced to ≤2/10 within the shift.
• Goal: The patient demonstrates relaxed posture and uninterrupted rest.

Evaluation: pain decreases to goal; patient rests comfortably; no escalation to flank pain.

Care plan 3 — Risk for Infection (spread or worsening)

Diagnosis. Risk for Infection related to urinary stasis, indwelling catheter, or inadequate hygiene.¹⁴

• Goal: The patient remains free of systemic infection (no new fever, chills, or flank pain).
• Goal: Any catheter is removed at the earliest appropriate time.

Evaluation: no systemic infection develops; catheter discontinued promptly; labs trend toward normal.

Care plan 4 — Hyperthermia

Diagnosis. Hyperthermia related to the infectious/inflammatory process, as evidenced by elevated temperature, flushed warm skin, and chills.¹⁴

• Goal: The patient’s temperature returns to normal limits within 24–48 hours of treatment.
• Goal: The patient stays hydrated and comfortable.

Evaluation: temperature normalizes; patient remains hydrated; no progression to systemic infection.

Care plan 5 — Deficient Knowledge

A prevention-focused nursing diagnosis for UTI is essential for patients with recurrent infections.

Diagnosis. Deficient Knowledge regarding UTI prevention and the treatment regimen, as evidenced by recurrent infections or questions about self-care.¹⁴

• Goal: The patient verbalizes at least 3 prevention strategies before discharge.
• Goal: The patient states the importance of completing the full antibiotic course.

Evaluation: patient teaches back prevention steps and the treatment plan accurately.

Pharmacologic management

Antibiotics treat the infection; everything else manages symptoms. Know the difference — the NCLEX loves to test it.

Antibiotics — uncomplicated cystitis (first-line per IDSA):³

• Nitrofurantoin (commonly 100 mg PO BID × 5 days). Great for bladder infections — but it does not reach adequate levels in kidney tissue, so it’s not used for pyelonephritis.³
• Trimethoprim-sulfamethoxazole (TMP-SMX / Bactrim) (160/800 mg PO BID × 3 days) — appropriate where local resistance is under 20%, or when the organism is known susceptible.³
• Fosfomycin (3 g single dose).³

Correction worth flagging. Metronidazole is not a UTI antibiotic. It covers anaerobes and certain protozoa and has no reliable activity against E. coli and the other aerobic organisms that cause UTIs.¹¹ If you saw it on an older version of this page, that was an error — leave it off your care plan.

Fluoroquinolones (ciprofloxacin, levofloxacin) work, but IDSA recommends reserving them for when other options won’t do, because of resistance and collateral damage; the FDA also carries boxed warnings about serious side effects (tendon, nerve, and CNS effects).³

Pyelonephritis is treated differently. Nitrofurantoin and fosfomycin don’t cut it for a kidney infection — these patients need agents that penetrate renal tissue (often a fluoroquinolone for outpatient-eligible cases), and sicker patients need IV therapy and admission.³

Symptom relief — not antibiotics:

• Phenazopyridine (AZO) is a urinary analgesic, not an antibiotic. It numbs the bladder/urethra to ease burning but does nothing to clear the infection.⁴ Teach patients: it turns urine reddish-orange (harmless, but can stain clothes and contact lenses), use it short-term only — generally a maximum of ~2 days alongside an antibiotic — and it carries warnings for methemoglobinemia and hemolytic anemia, especially in G6PD deficiency.⁴
• NSAIDs and acetaminophen for pain and fever. The nuance the old page got wrong: “always avoid NSAIDs in UTI” is not correct. The real risk is using an NSAID instead of an antibiotic — in one RCT, all pyelonephritis cases occurred in the ibuprofen-only group.⁸ Used alongside an antibiotic for symptom relief, NSAIDs are appropriate (with usual cautions for renal function, GI risk, and pregnancy).⁸

Safety reminder. Antibiotic selection always depends on local resistance, culture results, allergies, pregnancy, and renal function. For exam purposes, learn the first-line agents; in practice, follow culture sensitivities and provider orders.

When a UTI moves upstream: pyelonephritis

If bacteria climb from the bladder to the kidney, cystitis becomes pyelonephritis — an upper-tract infection that’s treated as more serious and, in nursing-school terms, complicated.¹

How pyelonephritis presents differently

A bladder infection is mostly local — burning, urgency, frequency. Pyelonephritis adds systemic, kidney-level findings:

• Flank pain and costovertebral angle (CVA) tenderness¹
• Fever, chills, nausea, and vomiting¹
• Often the lower-tract symptoms (dysuria, frequency) layered on top
• A patient who simply looks and feels sicker

Diagnostics and management that change

• Urine culture is essential here (not optional, as it sometimes is in simple cystitis), and blood cultures are drawn when the patient is febrile or looks septic.¹
• Imaging (CT urography or ultrasound) is added when the patient isn’t improving, or when obstruction or a stone is suspected.¹
• Antibiotics are different. Bladder-only agents — nitrofurantoin and fosfomycin — don’t reach kidney tissue and are inadequate for pyelonephritis.³ Outpatient-eligible patients are often started on an oral fluoroquinolone; patients who are vomiting or systemically ill need IV antibiotics, IV fluids, and admission.³ Final choice follows culture sensitivities.

Pyelonephritis nursing care plan: key priorities

Building a nursing diagnosis for acute pyelonephritis care plan reuses the same NANDA-I labels, but the priorities shift toward systemic illness:

• Hyperthermia and Acute Pain (flank, not just suprapubic) move up the list.
• Risk for Infection / Risk for Sepsis becomes central — monitor vital signs, mental status, and urine output closely for progression to urosepsis.
• Deficient Fluid Volume may apply when the patient is febrile and vomiting.¹⁴

Nursing priorities: closer monitoring (vitals, I&O, mental status), prompt IV antibiotics and fluids when ordered, antipyretics and analgesia for comfort, and early escalation. Untreated, pyelonephritis can progress to urosepsis — the next section.

Escalation red flags (urosepsis)

A UTI that spreads systemically can become urosepsis, a medical emergency. Escalate immediately if you see:

If these appear, notify the provider, anticipate cultures and IV antibiotics, and follow your facility’s sepsis protocol. When in doubt, escalate — urosepsis moves quickly.

Discharge and patient teaching

Prevention is where you keep patients from becoming repeat visitors. Teach:

You’ve got this. Once you can match the patient’s data to the right diagnosis, the rest of the UTI care plan falls into place — assess, treat, relieve symptoms, and teach prevention. Lock in the pattern and you’ll have it for both the NCLEX and the floor.

Charting it: FDAR example

Here’s how a UTI note might look in FDAR (Focus–Data–Action–Response) format:

• Focus: Acute pain and dysuria related to UTI.
• Data: Reports burning on urination, 6/10 suprapubic pain, frequency. Urine cloudy; dipstick positive for nitrites and leukocyte esterase. Temp 38.3°C.
• Action: Notified provider; obtained urine culture; administered ordered antibiotic and acetaminophen; encouraged fluids; taught phenazopyridine (symptom relief only, orange urine expected).
• Response: 2 hours post-intervention, pain 2/10; voided 250 mL clearer urine; temp 37.6°C. Verbalized understanding of fluid and hygiene teaching.

Prefer SOAP? Same data, different buckets:

• S (Subjective): “It burns when I pee and I keep needing to go.” Reports suprapubic pain 6/10.
• O (Objective): Urine cloudy; dipstick positive for nitrites and leukocyte esterase. Temp 38.3°C; suprapubic tenderness on palpation.
• A (Assessment): Acute Pain and Impaired Urinary Elimination related to UTI.
• P (Plan): Urine culture obtained; antibiotic and acetaminophen given; fluids encouraged; prevention teaching provided; reassess pain and temperature.

Match your charting to your facility’s documentation standard — FDAR, SOAP, or narrative.

NCLEX practice question

A nurse is caring for a client with an indwelling urinary catheter who develops a fever and new-onset confusion. Which nursing action is the priority?

• A. Encourage increased oral fluids
• B. Administer the ordered antipyretic
• C. Assess the catheter and notify the provider; anticipate cultures
• D. Teach the client front-to-back perineal hygiene

Answer: C. New fever and confusion in a catheterized patient suggest a possible CAUTI progressing toward urosepsis — a potential emergency. The priority is to assess, escalate to the provider, and anticipate cultures and treatment.^5,6 Fluids (A) and an antipyretic (B) are supportive but don’t address the urgent risk of systemic spread; teaching (D) is appropriate later, not during an acute change in status.

FAQs

Is a UTI a nursing diagnosis?

Not exactly — and this trips up a lot of students. A UTI is a medical diagnosis. Your nursing diagnoses are the patient’s responses to that infection: Acute Pain, Impaired Urinary Elimination, Risk for Infection, Hyperthermia, or Deficient Knowledge. So you don’t write “UTI” as the diagnosis — you write the human response the UTI is causing.¹⁴

What is the priority nursing diagnosis for UTI?

The priority nursing diagnosis for UTI depends on your patient’s strongest data, but Acute Pain and Impaired Urinary Elimination are the most common for simple cystitis. If the patient has a fever or signs of spreading infection, Risk for Infection or Hyperthermia may take priority because they tie to safety.¹⁴

What are the most common nursing interventions for a UTI?

Encourage fluids, promote regular and complete voiding, give antibiotics on schedule, manage pain and fever, monitor for worsening infection, and teach prevention. Pair every intervention with its rationale.^1,12

Is phenazopyridine (AZO) an antibiotic?

No. Phenazopyridine is a urinary analgesic that numbs bladder and urethral discomfort. It relieves symptoms but does not treat the infection, so it’s always used with an antibiotic — and only for about 2 days. Expect orange urine.⁴

Can you treat a UTI without antibiotics?

Antibiotics are the standard treatment for a symptomatic UTI. NSAIDs alone are not reliable — in one trial, NSAID-only treatment led to more cases of pyelonephritis.⁸ Cranberry may help prevent UTIs but doesn’t cure an active one.¹⁰ Always follow provider orders.

Which antibiotic is used for a UTI?

For uncomplicated cystitis, IDSA first-line options are nitrofurantoin, TMP-SMX (where resistance is low), and fosfomycin. Pyelonephritis needs agents that reach kidney tissue, so it’s treated differently. Final choice depends on culture results.³

Related resources

• Nursing Diagnosis
• Nursing Interventions
• Nursing Care Plan Template
• Nursing Process
• ADPIE
• Urinary Retention Nursing Care Plan
• Sepsis Nursing Care Plan
• Infection (Risk for Infection) Nursing Care Plan
• Acute Pain Nursing Care Plan
• Knowledge Deficit Nursing Care Plan

References

1. Bono MJ, Leslie SW, Reygaert WC. Uncomplicated Urinary Tract Infections. StatPearls, NCBI Bookshelf; updated 2025. https://www.ncbi.nlm.nih.gov/books/NBK470195/
2. Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections. PMC3351074. https://pmc.ncbi.nlm.nih.gov/articles/PMC3351074/
3. Gupta K, Hooton TM, Naber KG, et al. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women (IDSA/ESCMID 2010 Update). Clin Infect Dis. 2011;52(5):e103–e120. https://doi.org/10.1093/cid/ciq257
4. Eastham JH, Patel P. Phenazopyridine. StatPearls, NCBI Bookshelf; updated 2023. https://www.ncbi.nlm.nih.gov/books/NBK580545/
5. Krinitski D, et al. Urinary Tract Infection–Induced Delirium in Elderly Patients: A Systematic Review. PMC9827929. https://pmc.ncbi.nlm.nih.gov/articles/PMC9827929/
6. CDC (HICPAC). Guideline for Prevention of Catheter-Associated Urinary Tract Infections (CAUTI). https://www.cdc.gov/infection-control/hcp/cauti/index.html
7. U.S. FDA / DailyMed. Phenazopyridine Hydrochloride — Prescribing Information. https://dailymed.nlm.nih.gov/dailymed/
8. Vik I, Bollestad M, Grude N, et al. Ibuprofen versus pivmecillinam for uncomplicated UTI in women — a double-blind, randomized non-inferiority trial. PLoS Med. 2018;15(5):e1002569. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002569
9. Reygaert WC. Microbiology of uropathogens (within Ref 1). NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470195/
10. Williams G, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2023;(11):CD001321. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001321.pub7/full
11. U.S. FDA / DailyMed. Metronidazole — Prescribing Information (anaerobic spectrum). https://dailymed.nlm.nih.gov/dailymed/
12. Hooton TM, Vecchio M, Iroz A, et al. Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent UTIs: A Randomized Clinical Trial. JAMA Intern Med. 2018;178(11):1509–1515. https://pmc.ncbi.nlm.nih.gov/articles/PMC6584323/
13. AUA/CUA/SUFU. Recurrent Uncomplicated Urinary Tract Infections in Women: Guideline. American Urological Association. https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti
14. Herdman TH, Kamitsuru S, Lopes CT, eds. NANDA International Nursing Diagnoses: Definitions & Classification, 2024–2026 (13th ed.). Thieme; 2024. ISBN 9781684206018.

Source notes. NANDA-I labels reflect the 2024–2026 (13th ed.); verify exact wording against the official text. Antibiotic guidance reflects the IDSA/ESCMID uncomplicated cystitis and pyelonephritis guideline — always defer to current local resistance data, culture sensitivities, and provider orders.