emDocs - June 28, 2020 - By Mishra D and Curato M
Reviewed by: Montrief T; Koyfman A and Long B
"Take Home Points:
- A diagnosis of pyelonephritis is made through a combination of vital signs, clinical presentation, physical exam, and urinalysis. It is essential to take the entire clinical picture into account when deciding on a disposition for a patient
- Discharge home with oral antibiotics is an appropriate disposition plan for the majority of mild to moderately ill acute pyelonephritis patients who are able to tolerate oral intake and are not persistently tachycardic, hypotensive, or tachypneic. They should also have stable coexisting medical comorbidities, a reliable psychosocial situation, an appropriate oral antimicrobial regimen, and access to outpatient follow-up.
- It is important that, regardless of disposition decision, all of your patients have appropriate follow-up to assess for improvement in symptoms"