Management of Urosepsis in 2018

Despite optimal treatment, urosepsis has still high morbidity and mortality rates. An updated definition and classification system for sepsis have recently been introduced. Management of urosepsis comprises four major aspects: (1) early diagnosis, (2) early empiric intravenous antimicrobial treatment, (3) identification and control of complicating factors, and (4) specific sepsis therapy. The quick sequential organ failure assessment is replacing the systemic inflammatory response syndrome scoring for rapid identification of patients with urosepsis. Patient summary: Urosepsis is a serious, life-threatening complication of infections originating from the urinary tract. As urosepsis has a very high mortality rate, it is important that is quickly spotted and that appropriate treatment is swiftly begun. Imaging of urinary tract disorders has been shown to be useful in decreasing mortality from urosepsis, and in the future microbiology techniques may also prove useful. Given the severity of urosepsis and the associated risks, large efforts need to be made to prevent high-risk infections in hospitals with appropriate prevention measures, such as the early removal of catheters used whenever possible. (c) 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.