Complicated UTI (upper UTI)

First Line

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

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

Co-amoxiclav 625mg tds PO or Ciprofloxacin 500mg bd PO pending results

Penicillin Allergy

Vancomycin IV as per protocol + Ciprofloxacin 500mg bd PO

Notes

UTI+ sepsis

OR

Pyelonephritis +/- sepsis

OR

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

Treat for 7-14 days depending on the severity of infection and clinical response

Aim for no longer than three days of Gentamicin

 

If treatment fails check current microbiology results, seek senior clinical review +/- D/W microbiology