UTI, upper (acute pyelonephritis)

Pyelonephritis (Upper UTI) consists of fever, loin pain and urinary symptoms (WITH positive urinalysis)

Modify empirical treatment within 48 hours or when culture and sensitivity is available, whichever is sooner:

For patients with penicillin allergy label consider penicillin allergy assessment and delabelling

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Suspected urosepsis - see UTI with sepsis/ severe sepsis (Urosepsis)

Ambulatory management - see Ambulatory care: Urinary tract infection

For patients with high frailty score (i.e high risk of C.diff) - see UTI and functional decline

Pregnancy - see UTI, upper or acute pyelonephritis (pregnant )

NICE NG111 Pyelonephritis (acute): antimicrobial prescribing October 2018. Available: Overview | Pyelonephritis (acute): antimicrobial prescribing | Guidance | NICE

Last reviewed: 01 May 2025

Author(s): AMST.

Approved By: MMTC

Preferred