Acute Pyelonephritis

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

Co-trimoxazole

960mg twice daily

14 days

or co-amoxiclav

625mg three times daily

7 days

For serious, or potentially life-threatening, infection consider:

Ciprofloxacin

500mg twice daily

7 days

Review and rationalise treatment after 24 hours.