Outpatient Management of Acute Pyelonephritis
Write a prescription for acute pyelonephritis and have every line marked: drug choice, dose, route, frequency and duration, checked against the patient's allergies, current medicines, renal function and the interaction database, with each error explained.
medium8 scoring rulesrenal impairment
- Patient
- 45 years, male, 82 kg
- Diagnosis
- Acute pyelonephritis
- Renal function
- eGFR 52 mL/min/1.73m²
- Allergies
- penicillin
- Current medicines
- lisinopril 10 mg once daily
The scenario
Patient B-217, a 45-year-old man, presents with a two-day history of fever, rigors, and right loin pain. He has experienced dysuria and increased urinary frequency. He has no vomiting and is tolerating oral fluids. Examination: temperature 38.9°C, pulse 110 bpm, blood pressure 134/78 mmHg. Right costovertebral angle tenderness is present. Urine dipstick shows positive leukocyte esterase and nitrites. Blood tests: WBC 15.2 × 10^9/L, CRP 186 mg/L, serum creatinine 1.4 mg/dL (eGFR 52 mL/min/1.73 m²). Liver function tests are normal. His current medicines are lisinopril 10 mg once daily for hypertension. He has a documented penicillin allergy (rash). He weighs 82 kg. Please prescribe appropriate oral antibiotic therapy, analgesia, and provide safety-netting advice.
What gets marked
- Whether you chose an indicated drug, and whether you avoided the contraindicated ones.
- Dose, route, frequency and duration against the range for this patient.
- Renal and hepatic dose adjustment where this patient's numbers demand it.
- Allergy cross-reactivity and interactions with the medicines already on the chart.
- The instructions and monitoring you write, not only the drug you pick.
8 scoring rules apply to this scenario. A single critical error fails the attempt whatever the score.
Log in to prescribe for "Outpatient Management of Acute Pyelonephritis"
A free account opens the prescription pad: search the formulary, write the chart, and have it marked line by line by the safety engine.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.