Acute Pyelonephritis or UTI with Systemic Sepsis

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

Micro Organisms

E.Coli

First Line

Therapy

< 1 months old - Cefotaxime IV  +/- gentamicin IV  if further deterioration or no improvement for 7-10 days

> 1 months old - Ceftriaxone IV +/- gentamicin IV  if further deterioration or no improvement for 7-10 days

Notes:

Consider alternative antibiotic if temperature not settling after 48 hours

Switch to oral antibiotics once clinically improved.  Use C+S to guide choice. Nitrofurantoin is not suitable for the treatment of acute pyelonephritis or as an oral switch from IV treatment

Anaphylaxis (including severe skin reactions) to penicillin

Therapy

Vancomycin IV + Gentamicin IV for 7-10 days

Notes:

Switch to oral antibiotics once clinically improved.  Use C+S to guide choice. Nitrofurantoin is not suitable for the treatment of acute pyelonephritis or as an oral switch from IV treatment

Notes

 

Link to NICE Guideline

CKS - UTI in children