Pyelonephritis/ Urosepsis

Micro-organism

Escherichia coli

Proteus spp

Klebsiella spp

Duration

7 days

If abnormality of urinary tract consider longer course of 10 to 14 days.

Notes
  • Samples should be taken prior to starting treatment.
  • Send blood for culture if pyrexial.
Urosepsis - First line

Gentamicin¥ IV (Hartford Regimen) as per guideline

Use preferred calculator on Hospital portals page [intranet access only] or calculator on app

NB: if reduced or unstable renal function give single dose only then review with Infectious Diseases or Microbiology

PLUS Amoxicillin 1g IV 8 hourly

 

Switch to oral option guided by microbiology sensitivities

¥If > 72 hours IV therapy required replace gentamicin with temocillin IV 2g 12 hourly.

Urosepsis - Penicillin Allergy

Ciprofloxacin 500mg oral (or 400mg IV) 12 hourly

 

Switch to alternative oral option if indicated by microbiology sensitivities.

Notes

NB: Nitrofurantoin is not suitable for use in pyelonephritis