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Old 03-01-2016
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Default f/u urine culture in APN

In case of uncomplicated pyelonephritis that is well tolerated with oral antibiotics, do we need to do a f/u urine culture after the 14day course of therapy is over?

In Kaplan Qbank, it is stated that no f/u culture is needed. However, in step up to medicine, it says "repeat urine culture 2-4days after cessation of therapy." I am confused by these two totally different explanations.
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Old 03-01-2016
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Hey linal,

I checked my edition of Step-Up to Medicine and you're right that there is conflicting information. I also looked up uncomplicated pyelonephritis in uptodate and this is what I found:

"Follow-up urine cultures are not needed in patients with acute cystitis or pyelonephritis whose symptoms resolve on antibiotics.

Patients with acute cystitis or pyelonephritis who have persistent symptoms after 48 to 72 hours of appropriate antimicrobial therapy or recurrent symptoms within a few weeks of treatment should have evaluation for complicated infection as discussed separately. Urine culture should be repeated and empiric treatment should be initiated with another antimicrobial agent."

So therefore I don't think it's necessary. If something isn't 100% clinically clear, then they won't ask the question or they'll have to add extra information like mentioned above.
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