A 44-year-old woman presents with fever, flank pain and nausea. She has costovertebral angle tenderness and temperature 38.7 °C. She is vomiting and u...

Question

A 44-year-old woman presents with fever, flank pain and nausea. She has costovertebral angle tenderness and temperature 38.7 °C. She is vomiting and unable to keep down oral fluids. Urinalysis shows nitrites and leucocytes. What is the MOST appropriate management?

Accepted Answer

Admit for intravenous ceftriaxone and IV fluids

Answer

Oral nitrofurantoin 100 mg 6-hourly for 5 days at home

Answer

Oral trimethoprim 300 mg at home with GP review in 1 week

Answer

No antibiotics; arrange ultrasound first

Answer

Start long-term prophylactic antibiotics only

au-acem MCQ (SBA): Acute pyelonephritis

A 44-year-old woman presents with fever, flank pain and nausea. She has costovertebral angle tenderness and temperature 38.7 °C. She is vomiting and unable to keep down oral fluids. Urinalysis shows nitrites and leucocytes. What is the MOST appropriate management?