Community-acquired pyelonephritis/complicated UTI, outpatient

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

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