Urinary tract infection (UTI)is one of the most common bacterial infections that commonly occurs in both community and hospital-associated onset. Gram-negative Enterobacteriaceae, including Escherichia coli, Klebsiella species, and Proteus species, are causative pathogens of UTI [1,2]. Structural and functional urinary tract abnormalities cause complicated UTIs, leading to severe septic conditions that require systematic antibiotic treatment on admission. With an aging society, the number of complicated UTIs and urosepsis is estimated to increase year by year. Emergence of drug-resistant organisms such as carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant enterococci (VRE) is a severe problem that should be addressed [3,4]. Moreover, developments in biologics and immune checkpoint inhibitors have made it more difficult for physicians to make decisions when treating UTIs. Urosepsis is still a critical condition originating from a urinary tract infection. Despite advances in antimicrobial therapy and diagnostic methods such as radiological imaging and rapid microbial tests, the mortality rate remains high with an in-hospital mortality rate of 30–40 % [[5], [6], [7]]. Some prognostic guidelines and statements mentioned that patients with urosepsis should receive appropriate antibiotic therapy for 10–14 days as a standard treatment [8,9]. All countries face a surge in medical costs, which has recently become an economic problem. Regarding medical costs, long-term intravenous antibiotic treatment is an economic burden, leading to more staff labor. Switching to oral antibiotics is essential to save medical costs and staff labor [10,11]. However, no established clinical evidence exists in the treatment of urosepsis. Here, we describe the validity and efficacy of switching oral antibiotic therapy from intravenous therapy to treat urosepsis. This is the first report showing the validity and efficacy of an oral switch antibiotic therapy for urosepsis treatment using propensity-score matching analysis.