Comments from Expert Advisory Committee
- Send MSU for culture.
- Nitrofurantion- should be avoided after 36 weeks due to risk of neonatal haemolysis.
- Refer to local resistance patterns for empiric therapy where available and refer to MSU results. Amoxicillin resistance is common – only use if susceptibility data available.
- Review empirical treatment with results of MSU culture and susceptibility.
- Note guidelines on Asymptomatic Bacteriuria in Pregnancy
- If acute pyelonephritis is suspected, consider referral to hospital. Consider acute pyelonephritis/ upper UTI when:
- Pain in the loin which radiates to the iliac fossa and suprapubic area.
- Sudden onset general systemic disturbance with fever, rigors, vomiting.
- Tenderness and guarding over the kidney.
*Seek specialist/microbiologist advice in case of penicillin allergy in pregnant patients if nitrofurantoin is not an option.
Reviewed November 2021