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Leeds Acute Upper Urinary Tract Infection (Pyelonephritis) Pathway

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1 Background Information / Scope of Pathway

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This pathway has been developed jointly by the Leeds CCG planned care leads, Continence Urology and Colorectal Service (CUCS) and consultants from Urology, Urogynaecology and Elderly Medicine within LTHT.

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2 Development & Updates to this Pathway

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Developed November 2014

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3 Presents With Acute Upper Urinary Tract Infection Symptoms

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GP Information:

  • Fever
  • Loin Pain
  • Rigors
  • Systemically Unwell

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6 Unlikely Upper Urinary Tract Infection Manage Accordingly

Quick info:
Consider other causes of sepsis and manage accordingly

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7 Systematically Unwell or High Risk Patient Refer as Emergency Admission

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Arrange admission via PCAL

Primary Care Access Line (PCAL)
Telephone: 0113 2065996

Operational Hours
Monday - Friday: 7.00am to 10.00pm
Weekends and Bank Holidays: 8.00am to 10.00pm

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8 Empirical Management

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GP Information:
Treat with antibiotics

Please see LHP for prescribing guidance: Upper UTI (Acute pyelonephritis) in Adult Men Upper UTI (Acute pyelonephritis) in Adult Women

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10 Clinical Deterioration or Failure to Respond Refer as Emergency Admission

Quick info:
Arrange admission via PCAL

Primary Care Access Line (PCAL)
Telephone: 0113 2065996

Operational Hours
Monday - Friday: 7.00am to 10.00pm
Weekends and Bank Holidays: 8.00am to 10.00pm

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20 No Abnormality

Quick info:
GP Information:
Referral to Urology if any recurrence

Key Dates

Published: 21-Nov-2014, by Leeds
Valid until: 31-Aug-2016

References

This is a list of all the references that have passed critical appraisal for use in the care map Urology - Acute pyelonephritis
Reference

  1. Grabe M, Bishop MC, Bjerklund-Johansen TE. Guidelines on urological infections. The Netherlands: European Association of Urology; 2009. http://www.uroweb.org/fileadmin/tx_eauguidelines/2009/Full/Urological_Infections.pdf
  2. Scottish Intercollegiate Guidelines Network (SIGN). Management of suspected bacterial urinary tract infection in adults. Edinburgh: SIGN; 2006.
    http://www.sign.ac.uk/pdf/sign88.pdf
  3. Clinical Knowledge Summaries (CKS). Pyelonephritis - acute. Version 1.0. Newcastle upon Tyne: CKS;
    2009.
  4. Map of Medicine (MoM) Clinical Editorial team and Fellows, and independent reviewers. London: MoM;
    2011.
  5. Neumann I, Moore P. Pyelonephritis (acute) in non-pregnant women. Clin Evid (Online ) 2011; 2011:
    http://www.ncbi.nlm.nih.gov/pubmed/21477395
  6. Health Protection Agency (HPA). Management of infection guidance for primary care for consultation and local adaptation. London: HPA; 2010. http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1279888711402
  7. The Royal College of Physicians (RCP), the Academy of Medical Royal Colleges (AMRC). A clinician's guide to record standards - Part 1: Why standardise the structure and content of medical records?. London: Digital and Health Information Policy Directorate; 2008.
    http://www.aomrc.org.uk/publications/reports-guidance/doc_download/215-a-clinicians-guide-to-record- standards-part-1.html
  8. The Royal College of Physicians (RCP), the Academy of Medical Royal Colleges (AMRC). A clinician's guide to record standards - Part 2: Standards for the structure and content of medical records and communications when patients are admitted to hospital. London: Digital and Health Information Policy Directorate; 2008.
    http://www.aomrc.org.uk/publications/reports-guidance/doc_download/216-a-clinicians-guide-to-record- standards-part-2.html
  9. National Institute for Health and Clinical Excellence (NICE). Venous thromboembolism: reducing the risk.
    Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital. Clinical guideline 92. London: NICE; 2010. http://guidance.nice.org.uk/nicemedia/live/12695/47195/47195.pdf
  10. Vouloumanou EK, Rafailidis PI, Kazantzi MS et al. Early switch to oral versus intravenous antimicrobial treatment for hospitalized patients with acute pyelonephritis: a systematic review of randomized controlled trials. Curr Med Res Opin 2008; 24: 3423-3434.
    http://www.ncbi.nlm.nih.gov/pubmed/19032124