Monitoring
No monitoring is needed in otherwise healthy patients whose symptoms and signs improve after completion of therapy. Do not request routine post-treatment urine cultures or urinalysis in asymptomatic patients.[34]
Patients who are pregnant or have multiple medical problems or recurrent urinary tract infections may require repeat urine cultures to ensure bacteriological cure (<1,000 colony-forming units [CFU]/mL) after completing the antibiotic treatment regimen. Consider the causes for any treatment failure. Repeat imaging to determine the cause, if warranted. Careful attention to treatment of underlying medical problems, nutritional parameters, and/or other disease-specific modifying factors (e.g., lithotripsy in the case of renal stones) is essential.
Follow-up treatment in pregnant patients is important. They should be monitored closely throughout their pregnancy because of an increased risk of recurrent pyelonephritis.[74]
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