For a patient suspected of having pyelonephritis, what first step in management is recommended?

In cases of suspected pyelonephritis, the recommended first step in management is to initiate antibiotic therapy. This infection of the kidneys often requires prompt treatment to prevent complications such as abscess formation or progression to sepsis. Starting antibiotics early is crucial in effectively controlling the infection and mitigating symptoms, considering that pyelonephritis can present with significant morbidity.

While other options, such as diagnostic imaging (like a CT scan) or laboratory tests (like a complete blood count), can be part of the overall management plan, they are typically not the immediate priorities in the setting of suspected pyelonephritis. These tests may be useful in confirming the diagnosis or assessing severity but should not delay the initiation of appropriate antibiotic treatment. Immediate hospitalization may be necessary for certain patients, especially those with severe symptoms or underlying health issues, but it is not a universal requirement for all cases. Starting antibiotic therapy is the most critical and time-sensitive intervention in managing the suspected infection.