Critérios de internação para paciente com pielonefrite

Pyelonephritis is a more serious infection than cystitis; therefore, expected efficacy of an antimicrobial agent is of greater importance than concern about ecological adverse effects (selection of drug-resistant organisms and the development of colonization or infection with multidrug-resistant organisms). Outpatient management is acceptable for patients with mild to moderate illness who can be stabilized with rehydration and antibiotics in an outpatient facility and discharged on oral antibiotics under close supervision. Inpatient management is warranted in the setting of severe illness with high fever, pain, and marked debility, inability to maintain oral hydration or take oral medications, pregnancy, or concerns about patient compliance.

Complicated urinary tract infection (UTI)
urinary tract infection in a patient with any functional, metabolic, or anatomical condition that may increase risk of treatment failure or serious outcomes such as(1)
o diabetes mellitus
o immunocompromise
o pregnancy
o neurogenic bladder
o renal insufficiency
o nephrolithiasis
o indwelling urinary catheter
o urinary obstruction

Referências:

- Grabe M, Bjerklund-Johansen TE, Botto H, et al. European Association of Urology (EAU). Guidelines on urological infections. EAU 2013 Mar PDF
Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012 Mar 15;366(11):1028-37
- Fihn SD. Clinical practice. Acute uncomplicated urinary tract infection in women. N Engl J Med. 2003 Jul 17;349(3):259-66, commentary can be found in N Engl J Med 2003 Oct 23;349(17):1674 full-text
- Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012 Mar 15;366(11):1028-37