Impact of Introduction of a Clinical Pathway for the Management of Pyelonephritis on Obstetric Patients: a Quality Improvement Project

Abstract

Acute pyelonephritis is one of the most common medical complications of pregnancy. It occurs in 0.5–2% of pregnant women and can result in significant maternal and fetal morbidity1,2. Additionally there is a financial burden on the hospital due to prolonged inpatient stays, increased preterm birth rate and associated neonatal care 3. Although there have been many studies evaluating the benefit of treating asymptomatic bacteriuria to prevent pyelonephritis in pregnancy, there is little recent evidence around how to treat pyelonephritis in pregnancy 4-6. In 1995 a study was published which showed the benefit of ceftriaxone in pregnancy, when compared to cefazolin but did not address issues such as prophylaxis during the remaining pregnancy and need for additional gentamicin