Acute Pyelonephritis
Antimicrobial prescribing: NHS Forth Valley
Classic presentation – triad of
- Fever
- Costovertebral/loin pain
- Nausea/vomiting
- +/- cystitis
If admission not needed, send MSU for culture & susceptibility and start antibiotics.
Review previous microbiology results and antibiotic sensitivities to guide empirical antibiotic.
Drug details
Cefalexin
1g TDS
7 days
Co-trimoxazole
960mg BD
7 days
Alternative options (preferrably if sensitivity confirmed on recent culture)
e.g. hypersensitivity, drug interaction, renal impairment
Co-amoxiclav
625mg TDS
7 days
If multidrug resistant organism isolated on culture e.g. without oral treatment options and ongoing/deteriorating symptoms but not requiring hospital admission - consider discussion with OPAT service for potential outpatient IV antibiotic therapy