Final answer:
Outpatient treatment for pyelonephritis is often given to stable patients who can manage oral antibiotics and have no signs of complications. Suitable candidates are typically non-pregnant, without diabetes or weak immune systems and can ensure proper follow-up. Cases with resistant bacteria or severe symptoms require hospitalization and intravenous treatments.
Step-by-step explanation:
Outpatient treatment for pyelonephritis is usually reserved for individuals who are clinically stable and can take oral antibiotics. It's important for patients to show no signs of systemic complications like sepsis. Outpatient treatment may include a course of oral antibiotics such as fluoroquinolones, cephalosporins, or trimethoprim and sulfamethoxazole, provided the bacteria are not resistant to these medications. Adequate follow-up is important to ensure the resolution of the infection.
Patients with mild to moderate cases who don't have signs of systemic illness, have no nausea or vomiting that would interfere with oral medication, have normal renal function, and no significant comorbidities are usually the ones considered for outpatient care. Additionally, those who are not pregnant, do not have diabetes, or weakened immune systems and have a reliable social situation are also good candidates for outpatient therapy.
However, if the Klebsiella pneumoniae strain shows significant antimicrobial resistance or if the patient is showing signs of septic shock, as seen in some severe cases mentioned, inpatient treatment with intravenous antibiotics and supportive care is required. A culture from the urine along with a drug sensitivity test would be necessary to determine the effective antibiotics, especially if resistance is suspected.