A 32-year-old woman presents with fever, flank pain and dysuria. She is tachycardic, febrile at 38.8 °C and has right costovertebral angle tenderness....

Question

A 32-year-old woman presents with fever, flank pain and dysuria. She is tachycardic, febrile at 38.8 °C and has right costovertebral angle tenderness. You diagnose acute pyelonephritis. She is vomiting and unable to tolerate oral medications. What is the most appropriate initial management?

Accepted Answer

Admission for intravenous ceftriaxone and fluids

Answer

Oral nitrofurantoin for 5 days at home

Answer

Single-dose intramuscular ceftriaxone then discharge

Answer

No antibiotics until urine culture is available

Answer

Oral trimethoprim alone

au-amc MCQ (SBA): Acute pyelonephritis

A 32-year-old woman presents with fever, flank pain and dysuria. She is tachycardic, febrile at 38.8 °C and has right costovertebral angle tenderness. You diagnose acute pyelonephritis. She is vomiting and unable to tolerate oral medications. What is the most appropriate initial management?