Community-acquired pyelonephritis/complicated UTI, outpatient

Patient Population: Adult

Diagnosis	Common Pathogens	Drug(s) of First Choice	Alternative Drug(s)	Comments	Expected Duration
Community-acquired pyelonephritis/complicated UTI, outpatient	Enterobacteriaceae (E. coli) Enterococci	Ciprofloxacin	Ceftriaxone X 1 dose PLUS Trimethoprim/Sulfamethoxazole OR oral β-lactam (amoxicillin/clavulanate, cefuroxime, cefpodoxime)	Trimethoprim-sulfamethoxazole is preferred if organism is susceptible. Consider a single intravenous dose of ceftriaxone prior to fluoroquinolone therapy if patient is at high risk for fluoroquinolone-resistant organisms	7 days Urinalysis and urine culture should be performed and therapy adjusted based on culture and sensitivity

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Expected Duration

Community-acquired pyelonephritis/complicated UTI, outpatient

Enterobacteriaceae (E. coli)

Enterococci

Ceftriaxone X 1 dose

PLUS

Trimethoprim-sulfamethoxazole is preferred if organism is susceptible.

Consider a single intravenous dose of ceftriaxone prior to fluoroquinolone therapy if patient is at high risk for fluoroquinolone-resistant organisms

7 days

Urinalysis and urine culture should be performed and therapy adjusted based on culture and sensitivity

Clinical Infectious Diseases, Volume 52, Issue 5, 1 March 2011, Pages e103–e120, https://doi.org/10.1093/cid/ciq257

Infectious Diseases Management Program at UCSF