Complicated UTI (including urinary sepsis and pyelonephritis)

First Line

Gentamicin IV as per protocol AND Amoxicillin 1g IV 8 hourly


If felt hospital admission is not required and no evidence of previous resistance:

Co-amoxiclav 625mg PO 8 hourly or Ciprofloxacin 500mg PO 12 hourly (consider safety issues) or Cefalexin 1.5g PO 8 hourly pending results

Penicillin Allergy

Gentamicin IV as per protocol


Vancomycin IV as per protocol


UTI + sepsis


Pyelonephritis +/- sepsis


CAUTI + sepsis in men and women

Advice from Urology/Microbiology :-  Do not routinely change catheters for simple UTIs. Consider catheter change if severe sepsis or infection not resolving on treatment.

Send blood culture and urine and follow up results

Check previous urine results for guidance


Treatment duration: 7 days

If poor clinical response: review microbiology results, consider complicated infection (e.g. perinephric abscess, obstruction) seek senior clinical review 



Oral switch guidance

Review culture results first. If no positive microbiology to guide:

Preferred regime - Co-amoxiclav 625mg PO 8 hourly

Alternative - Co-trimoxazole 960mg PO 12 hourly or Ciprofloxacin 500mg PO 12 hourly (consider safety issues)