Discharge:

• Healthy + young females + tolerating PO + well appearing
• Admit anyone else
• Pregnancy gets admitted for increased risk for preterm labor. 

Should you send blood culture if admit?

• about 30% of patients will have positive blood culture but 97% will grow the same bug in urine as in blood therefore urine culture is adequate
• send blood culture if patient is septic or concerned for renal abscess

When should you think about renal abscess?

• failing outpatient or inpatient therapy for pyelonephritis
• consider this for diabetics who are at highest risk for this and for emphysematous pyelonephritis (necrotizing infection of kidney that is rapidly progressive with a 20% mortality)