› ! Urinary tract infection (uncomplicated) → › ! Urinary Retention → › Pelvic Inflammatory Disease (PID) → › Time critical stabilization
› If SBP < 90 mmHg, resuscitation bay
› If severe pain with peritonitis, surgical consult activation
› If pregnant with pain and bleeding, urgent pelvic ultrasound pathway
Analgesia and symptom control
› Symptom control
› Acetaminophen PO 1000 mg once
› Ketorolac IV 15 mg once
› Ondansetron ODT 4 mg once
› Sequencing
› Pregnancy test before ionizing imaging in reproductive potential
› Urinalysis early in all urinary phenotypes
› Pelvic ultrasound early in pregnancy or torsion concern
Condition specific pathways
› Cystitis pathway
› Nitrofurantoin PO 100 mg twice daily
› Duration 5 days
› Avoid if suspected pyelonephritis
› Pyelonephritis pathway
› Ceftriaxone IV 1 g once
› Oral step down per local resistance patterns
› Blood cultures if septic physiology
› Ureteral stone pathway
› NSAID first line if no contraindications
› Tamsulosin PO 0.4 mg daily if distal stone suspected
› Urology consult if infected obstruction concern
› PID pathway
› Ceftriaxone IM 500 mg once
› Doxycycline PO 100 mg twice daily
› Metronidazole PO 500 mg twice daily
› Duration 14 days
› Reassessment
› Pain score trend every 30 to 60 minutes until controlled
› Repeat vitals after analgesia and fluids
› Escalate if new peritonitis or worsening instability
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