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Management

Indications For Hospital Admission

Severely ill or evidence of sepsis
Presence of complications
Concern about compliance
Failure to respond to outpatient treatment
Inability to maintain oral hydration or take medications, vomiting, dehydration
Uncertainty about the diagnosis

Follow Up

Acute Uncomplicated Cystitis

Routine post-treatment urinalysis or culture is not indicated in asymptomatic patients
Urine culture and antimicrobial susceptibility testing are indicated in patients who remain symptomatic after completion of treatment or if patient has recurrence of symptoms within 2 weeks
- Retreatment with another agent for 7 days should be considered
Antimicrobial agent must be changed empirically pending the result of post-treatment urine culture and sensitivity testing in patients showing poor response to therapy

Acute Uncomplicated Pyelonephritis

After improvement, which is usually apparent within 48-72 hours, switch parenteral antibiotic to oral regimen to complete 1- to 2-week course of therapy
Post-treatment urinalysis and urine culture are not needed in patients who respond and remain asymptomatic
Radiologic (eg renal ultrasound, CT or renal scintigraphy) and urologic evaluation, and repeat urine culture/susceptibility testing are indicated in patients who remain febrile within ≥72 hours of treatment or if patient has recurrence of symptoms within 2 weeks
- Alternative tailored treatment should be considered in the absence of urological abnormality
- Rule out possible complications (eg nephrolithiasis, renal or perirenal abscess) in patients who relapse with the same pathogen

The role of oral antivirals in COVID-19 treatment: Who, when, and how?

Dr. Roger Paredes, Dr. Nicola Petrosillo, Dr. Petrick Periyasamy, 30 Jan 2023

Though most countries have eased pandemic restrictions, there is no room for complacency in managing COVID-19, which continues to cause significant morbidity and mortality.

At a recent symposium, esteemed experts Dr Roger Paredes, Head of Department of Infectious Diseases at the Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain, and Dr Nicola Petrosillo, Head of the Infection Prevention and Control and Infectious Disease Service at University Hospital Campus Bio-Medico, Rome, Italy, gave global perspectives on the continuing unmet needs in the COVID-19 outpatient landscape and discussed the role of antiviral treatment options in patients at risk of progressing to severe COVID-19. Dr Petrick Periyasamy, Head of Infectious Diseases Unit, Medical Department, UKM Medical Centre, Kuala Lumpur, Malaysia, chaired the session.

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Turning the TIDES with Dengue Vaccination

15 Dec 2022

Aedes aegypti mosquito is the epitome of ‘small bite, big threat’. A bite from a female Aedes aegypti mosquito is enough to spread dengue. There are four different serotypes of dengue virus, Dengue Virus 1–4 (DENV1–4), thus, individuals can be infected with dengue up to four times. Repeated infections increase the risk of severe dengue, a risk factor for mortality. These serotypes are endemic to a certain countries and cocirculate in the natural environment. Dengue poses a major global health concern, with approximately 40% of the world’s population at risk of infection and more severe cases linked to a 20% mortality rate.