To evaluate the clinical efficacy and safety of β-lactam antibiotics (BLAs) combined with tigecycline (TGC) in the treatment of complicated urinary tract infections (cUTIs) in perimenopausal women, and to provide evidence-based data for optimizing clinical treatment regimens in this population.

A retrospective study was conducted on the clinical data of 102 perimenopausal women with cUTI admitted to our hospital from March 2023 to March 2025. The patients were divided into a experimental group (52 cases) and a control group (50 cases) based on treatment regimens. The control group received BLAs (cefoperazone-sulbactam) monotherapy, while the treatment group received BLAs combined with TGC therapy. Both groups underwent continuous treatment for 14 days. Changes in various indicators before and after treatment were recorded.

After treatment, the white blood cell (WBC) counts in the control group and the experimental group were (8.21±1.19)×10 and (7.55±1.22)×10/L, respectively; serum amyloid A (SAA) levels were (25.31±4.65) and (22.91±4.12) mg·L^-1, respectively; soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) levels were (22.52±4.18) and (20.85±3.55) pg·mL^-1, respectively; urinary heparin-binding protein (U-HBP) levels were (77.60±8.54) and (74.06±7.43) ng·mL^-1, respectively. The CD4⁺/CD8⁺ ratios were 1.62±0.20 and 1.74±0.25, immunoglobulin M (IgM) levels were (1.57±0.20) and (1.72±0.28) g·L^-1, and immunoglobulin G (IgG) levels were (11.33±1.71) and (12.06±1.46) g·L^-1 in the two groups, respectively. In the visual analogue scale (VAS) assessment, the urgency VAS scores were 1.66±0.48 and 1.44±0.50, dysuria VAS scores were 1.90±0.36 and 1.71±0.50, and frequency VAS scores were 1.76±0.48 and 1.54±0.54 in the control group and the experimental group, respectively. The scores of physiological function, mental health, role-emotional, social functioning, vitality, general health, bodily pain, and role-physical were (82.26±8.29) vs. (86.88±9.10), (77.22±7.12) vs. (80.56±8.60), (79.82±8.49) vs. (83.92±9.83), (79.28±8.12) vs. (82.79±8.70), (81.54±9.50) vs. (85.44±8.63), (79.30±7.97) vs. (83.67±8.94), (79.52±8.10) vs. (84.96±9.15), and (82.96±9.17) vs. (87.04±8.71) in the control and experimental groups, respectively. All the above differences were statistically significant (all P<0.05). The total incidence rates of adverse reactions were 8.00% (4 cases/50 cases) in the control group and 5.77% (3 cases/52 cases) in the experimental group, with no statistically significant difference (P>0.05).

Compared with monotherapy with β-lactam antibiotics, combination therapy with tigecycline further improves urinary bacterial clearance rate and cure rate, as well as enhance inflammatory markers, immune function, clinical symptoms, and quality of life. However, there is no statistically significant difference in overall response rates between the two groups. The combination therapy dose not increase adverse drug reactions.