Spectrum: Local Antimicrobial Stewardship, for Prisma Health-Midlands

Acute Cystitis and Pyelonephritis (Outpatient)

Does the patient have urinary symptoms?

No - Patient is asymptomatic

Yes - Suggestive of acute cystitis

  • Lower urinary symptoms/signs (e.g. dysuria, new or increased frequency or urgency, suprapubic tenderness)

  • Pyuria on urinalysis

  • Temperature <38ºC

Yes - Suggestive of acute pyelonephritis

  • Fever >38ºC

  • Unilateral back or flank pain

  • Costovertebral angle tenderness ± radiologic evidence of kidney involvement