GuidelinesOther guideline
Pyelonephritis
Infection Pyelonephritis Brief outline/clinical setting Similar organisms but culture mandatory: If not septic (infection plus organ dysfunction) oral outpatient therapy Aetiologies/organisms Enterobacterales: E. coli, K. pneumoniae, Enterobacter spp, Proteus spp S. saprophyticus, Group B streptococcus, Enterococcus spp. Optimal antimicrobial selection Oral ciprofloxacin 500mg BD or levofloxacin
| Infection | Pyelonephritis |
|---|---|
| Brief outline/clinical setting | Similar organisms but culture mandatory: If not septic (infection plus organ dysfunction) oral outpatient therapy |
| Aetiologies/organisms | Enterobacterales: E. coli, K. pneumoniae, Enterobacter spp, Proteus spp S. saprophyticus, Group B streptococcus, Enterococcus spp. |
| Optimal antimicrobial selection | Oral ciprofloxacin 500mg BD or levofloxacin 750mg daily or 500mg BD & de-escalate when culture available. Hospitalised patients: Ceftriaxone 1gram BD IVI: (level of evidence 3; recommendation grade: strong) Cefuroxime 1.5g 8hrly IVI: (level of evidence 3; recommendation grade: strong) |
| Duration | Once culture results are available, the patient has defervesced, and can take orally, oral switch according to sensitivity is recommended; (level of evidence 1; recommendation grade: strong The recommended agents are, B-lactams (amoxicillin, amoxicillin/clavulanate, cefpodoxime, cefuroxime, cefixime) and TMP/SMX as per above doses. Fluoroquinolones can be used if they are the only oral agents to which the organism is sensitive and if used would allow discharge. |
| Alternative if allergic/not available | |
| Rationale | |
| Level of evidence |