A patient with a history of Afib, maintained in NSR with sotalol, is hospitalized for acute pyelonephritis. What antibiotic regimen is appropriate?

The appropriate antibiotic regimen for a patient hospitalized with acute pyelonephritis is IV Ceftriaxone. This choice is correct due to several reasons. First, ceftriaxone is a broad-spectrum cephalosporin that provides excellent coverage against common pathogens associated with pyelonephritis, including Escherichia coli and other Enterobacteriaceae. It is often preferred in cases of severe infection or when the patient requires hospitalization due to the severity of their condition, as IV administration allows for rapid achievement of therapeutic levels.

Moreover, in the setting of acute pyelonephritis, especially given the inpatient status, intravenous antibiotics are usually recommended for adequate tissue penetration and more reliable dosing compared to oral routes. This is crucial in instances where the infection is more severe or if there are concerns about compliance with oral medications.

When considering other options, while PO Ciprofloxacin can also be used in outpatient settings for uncomplicated cases, it may not be the most appropriate choice for a hospitalized patient with acute pyelonephritis, where IV therapy is typically indicated. IV Vancomycin is more suited for suspected or confirmed infections with resistant Gram-positive organisms, such as MRSA, and is not the first-line treatment for pyelone