Acute Pyelonephritis

Acute pyelonephritis


Classic presentation – triad of

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

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

If no response within 24 hours, admit.

If ESBL risk, oral options are limited – discuss with microbiology

Check any previous sensitivites


500mg BD

7 days

or co-amoxiclav

500/125mg TDS

7 days

If lab report shows sensitive: trimethoprim

200mg BD

14 days