This protocol applies to patients with acute pyelonephritis whose clinical severity warrants hospital admission and initiation of an intravenous antimicrobial regimen.
In patients with early culture results indicating multi-drug resistant organisms, a last-line alternative parenteral therapy is available. This step is considered selectively — the specific agents and regimen are defined in the full protocol.
Management begins with intravenous antimicrobial therapy. For cases where early culture confirms multi-drug resistant organisms, selected last-line parenteral agents are indicated — the full protocol details which agents apply and under what conditions.