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POAC funding for Pyelonephritis

Criteria

POAC may fund treatment for patients with pyelonephritis when care is clinically appropriate to be delivered in the community and avoids hospital admission. This typically includes intravenous fluids, IV antibiotics, and follow-up monitoring.

Please note: ultrasound imaging is not usually indicated and is not funded under POAC for pyelonephritis.

Funded Services:

  • A single dose of intravenous (IV) gentamicin if the patient is physiologically stable (pulse, blood pressure, peripheral circulation, hydration) and has either:

    • uncomplicated pyelonephritis with vomiting and mild dehydration.

    • uncomplicated pyelonephritis and failed oral treatment.

  • A single dose of ceftriaxone may be used to avoid acute hospital admission, if gentamycin is not available:

  • IV fluids, where appropriate, for a maximum of 24 hours. See Dehydration in Adults.

  • A review appointment:

    • for patients treated with oral antibiotics who are deteriorating

    • 24 hours after IV antibiotics

Treatment outside these parameters will only be funded on advice from a named and documented hospital specialist.

POAC Funding

Submit a new referral and claim using the PMS POAC form.  Use code 'Pyelonephritis'.

IV administration of gentamicin with fluids: $200

IV administration of ceftriaxone with fluids*: $200

Notes:

  • Single dose only funded. 

  • *IV ceftriaxone should be used only if gentamicin is not available and the alternative is admission to hospital

  • Available unfunded on MPSO.

  • The claimable fee includes the cost of gentamicin

  • A GP review will be funded if the patient is deteriorating on oral antibiotics

See POAC claiming schedule here

 

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