Acute Uncomplicated Pyelonephritis

Question 1

Urosepsis - definition - 5

Answer 1

UTI + 2 of the following signs of sepsis:
• Fever >38°C or <36°C
• HR >90 beats/min
• RR >20/min or PaCO2 <32mmHg
• WBC >12000/μl or <4000/μl or >10% band forms (left shift)

Question 2

Treatment goal

Answer 2

Aim is to achieve adequate antibiotic levels in both serum and urine

Question 3

PO - options - 3

Answer 3

• Fluoroquinolone ± single dose ceftriaxone/ aminoglycoside
• Trimethoprim- sulfamethoxazole + single dose ceftriaxone/aminoglycoside
• β lactam + single dose ceftriaxone/aminoglycoside

Question 4

IV - options - 3

Answer 4

• Fluoroquinolone
• Extended spectrum β lactam (ceftriaxone, piperacillin - tazobactam, carbapenem)
• Aminoglycoside

Question 5

Duration

Answer 5

Duration- for fluoroquinolone based treatment- 5/7d, all others-14d.