NICE guidelines on assessment and management of pyelonephritis here.
BNSSG guidelines on management of pyelonephritis here.
Consider admission if the patient:
- Is significantly dehydrated or unable to take oral fluids and medicines.
- Is pregnant.
- Has a higher risk of developing complications, e.g. people with known or suspected structural or functional abnormality of the genitourinary tract or underlying disease (such as diabetes mellitus, or immunosuppression).
We would recommend that patients with suspected pyelonephritis are seen face to face for a full examination and investigations including urine dip and urinary pregnancy test if appropriate.
Sometimes it may be safe to manage the patient remotely. In this instances please ensure that a urine sample is collected before antibiotics are commenced. During the OOH period an appointment can be made for this to be dropped off at an urgent treatment centre to be sent for MCS.