Question

A 30-year-old woman presents with fever, flank pain and rigors. She has costovertebral angle tenderness and is nauseated but haemodynamically stable. She can tolerate oral fluids. What is the most appropriate management of suspected acute pyelonephritis in this otherwise healthy woman?

Accepted Answer

Oral cephalexin 500 mg 6-hourly for at least 7-10 days with close follow-up

Answer

Oral trimethoprim 300 mg daily for 3 days at home

Answer

Single IM dose of ceftriaxone with no further antibiotics

Answer

No antibiotics and arrange ultrasound

Answer

Immediate ICU admission for intravenous meropenem

Practice question

A 30-year-old woman presents with fever, flank pain and rigors. She has costovertebral angle tenderness and is nauseated but haemodynamically stable. She can tolerate oral fluids. What is the most appropriate management of suspected acute pyelonephritis in this otherwise healthy woman?