Acute Pyelonephritis

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Diagnosed when a UTI is accompanied by nausea, vomiting, fever, rigors and loin pain. Dysuria may be absent. Treat for 2 weeks.

Mild acute pyelonephritis

Medicine	Adult dose	Frequency	Duration
amoxicillin/clavulanic acid po	625mg	2 times a day	2 weeks

Acutely ill patients: use IV antibiotics until apyrexial, and then change to oral therapy.

	Medicine	Adult dose	Frequency	Duration
	ceftriaxone iv	1g	once a day	review
or	gentamicin* iv	4-7mg/kg	once a day	review

*Remember gentamicin toxicity is manifested after 7-10 days of use. Check gentamicin levels where possible. Avoid the nephrotoxic medicines gentamicin and nitrofurantoin in renal dysfunction.