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<< Diagnosis And Management Of Urinary Tract Infections In The Emergency Department

Disposition For Urinary Tract Infections

The main indications for hospitalization are intractable nausea or vomiting (ie, inability to tolerate fluids), hemodynamic instability (including severe sepsis/septic shock), and the presence of complications (eg, obstruction, emphysematous pyelonephritis). Other reasons for hospitalization may include the existence of concomitant immunocompromised states (eg, diabetes mellitus, cancer), the presence of indwelling catheters, failure of outpatient therapy, and poor social support (eg, inability to purchase medications or follow up as recommended, or homelessness).41 Patients who present with nausea and vomiting who improve with treatment in the ED may be safe to discharge without an inpatient stay.122,123 The patient should be immunocompetent and have adequate follow-up.124 There is also literature to support a single-dose treatment with intravenous antibiotics prior to discharge.125,126 The patient should give a reliable way to be contacted for culture results, if obtained.

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