Although there are no prospective randomized controlled trials looking specifically at ED patients with UTI symptoms, it is safe to say that a urine culture in healthy adult non-pregnant females with new onset urinary symptoms without concern for pyelonephritis or bacteraemia is unlikely to change management or outcome… SO STOP ORDERING THEM
The recommendation for an initial fluid bolus of 30 mL/kg was downgraded from a strong recommendation to a weak recommendation, based on the low quality of evidence. However, resuscitation should start immediately. Balanced crystalloid solution (e.g., lactated Ringer’s solution) should be used (rather than normal saline) for resuscitation. Administration of vasopressors should be initiated via […]
Antibiotics after I&D lead to significantly better outcomes with significantly fewer antibiotic-treated participants having clinical failure requiring a new antibiotic or another drainage procedure. New abscesses may develop in 10.1 percent of the antibiotic group compared to 19.1 percent of the placebo group.
…if your patient needs BiPAP or ICU, they should also get antibiotics!
NEW SEPSIS PATHWAY FLUIDS ANTIBIOTICS …for every hour you delay, the patient has a 33% increased risk of death! LACTATE
Most DO NOT need a chest X-ray performed and a high WBC is common as a result both of stress as well as steroid use NOT A SIGN OF INFECTION so DON’T order labs or give antibiotics unless there are other features of infection.