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Antimicrobials
Step down to oral once tolerating PO intake and improving
Beta-lactams including cephalexin, cefuroxime, cefixime, amoxicillin, and amoxicillin-clavulanate may be used if susceptible but require 14d of therapy
TMP-SMX is preferred when susceptible for a duration of 7-10 days
Fluoroquinolones may be used for a duration of 7 days
Fosfomycin and nitrofurantoin can NOT be used for pyelonephritis due to inadequate tissue penetration
Ertapenem should generally be used for ESBL pyelonephritis
Shorter duration antimicrobial therapy may be appropriate in some cases
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