Pyelonephritis/ Urosepsis | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Grampian, Orkney & Shetland
Hospital Guidance for Adults
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Urinary Tract
Pyelonephritis/ Urosepsis

Update your RDS mobile app to v4.7.1 to download toolkits even when website is down,

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Micro Organisms

Escherichia coli

Proteus spp

Klebsiella spp

Duration

7 days

If abnormality of urinary tract consider longer course of 10 to 14 days.

Notes

Important: Therapy

Samples should be taken prior to starting treatment.
Send blood for culture if pyrexial.

Notes:

Urosepsis - First line

Important: Therapy

Gentamicin^¥ IV (Hartford Regimen) as per guideline

Use preferred calculator on Hospital portals page [intranet access only] or calculator on app

NB: if reduced or unstable renal function give single dose only then review with Infectious Diseases or Microbiology

PLUS Amoxicillin 1g IV 8 hourly

Switch to oral option guided by microbiology sensitivities

Notes:

^¥If > 72 hours IV therapy required replace gentamicin with temocillin IV 2g 12 hourly.

Urosepsis - Penicillin Allergy

Important: Therapy

Ciprofloxacin 500mg oral (or 400mg IV) 12 hourly

Switch to alternative oral option if indicated by microbiology sensitivities.

Notes:

Avoid ciprofloxacin in frail elderly patients where possible due to CDI risk. Check important safety information in BNF & give MHRA patient information leaflet to patient

Important: Notes

NB: Nitrofurantoin is not suitable for use in pyelonephritis