Acute Pyelonephritis

Acute pyelonephritis


Classic presentation – triad of

  • Fever
  • Costovertebral/loin pain
  • Nausea/vomiting
  • +/- cystitis

If admission not needed, send MSU for culture & susceptibility and start antibiotics.

If no response within 24 hours, admit.

Review previous microbiology results and antibiotic sensitivities to guide empirical antibiotic. 


625mg TDS

7 days

or Cefalexin

1.5g TDS

7 days

If urine culture is sensitive: Trimethoprim

200mg BD

14 days

(consider safety issues)

500mg BD

7 days