A 27-year-old woman presents with flank pain, fever 38.9 °C and nausea. She has costovertebral angle tenderness and is systemically unwell. Urinalysis...

Question

A 27-year-old woman presents with flank pain, fever 38.9 °C and nausea. She has costovertebral angle tenderness and is systemically unwell. Urinalysis shows leucocytes and nitrites. What is the most appropriate initial management?

Accepted Answer

Intravenous ceftriaxone

Answer

Oral nitrofurantoin for 3 days

Answer

Oral trimethoprim for 5 days

Answer

No antibiotics; treat with analgesia only

Answer

Single-dose fosfomycin

au-amc MCQ (SBA): Acute pyelonephritis

A 27-year-old woman presents with flank pain, fever 38.9 °C and nausea. She has costovertebral angle tenderness and is systemically unwell. Urinalysis shows leucocytes and nitrites. What is the most appropriate initial management?