Pregnancy is associated with decreased ureteral motility and mild hydronephrosis. Therefore, there is an increased risk of both lower and upper UTI. Given the increased materno-fetal morbidity associated with pyelonephritis, traditional practice calls for inpatient treatment. Due to the considerable risk to patient/fetus, most emergency clinicians and obstetricians admit pregnant women for parenteral antibiotics such as a second- or third-generation cephalosporin, gentamicin, or aztreonam.84,86,95 There is some evidence (1b) to suggest an outpatient option for these patients.96 The patients were mild to moderately ill, and received 2 doses of intramuscular ceftriaxone prior to discharge with very close follow-up (48-72 hours).19,24,83-86,95-100
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