Upper urinary tract infection/pyelonephritis in pregnancy

The diagnosis is made with evidence of systemic infection e.g. fevers, rigors, back pain, and vomiting.

  • Review Sepsis in Obstetrics guideline on the intranet

Required Investigation

  • Send a urine sample and blood for culture

Antibiotic recommendations

Recommended total duration: 14 days 

Recommended Antibiotic Cefuroxime 1.5g every 8 hours IV
Penicillin anaphylaxis or cephalosporin allergyGentamicin use NHS Lothian AMT calculator on the intranet if day 3 or more postpartum otherwise follow Sepsis in Obstetrics guideline

IV to oral switch

Change to oral therapy when the patient is able to tolerate oral medication.
Choose oral antibiotics based on microbiological sensitivities.
Do not use nitrofurantoin to treat a systemic infection; effective blood and kidney concentrations are not achieved.