Pyelonephritis

Updated: July 23, 2024

Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

cefadroxil

Indicated for mild/moderate lower urinary tract infections like cystitis:

1 - 2

Orally

once a day

or can be provided in divided doses twice a day
severe urinary tract infections: 1 gram orally given in divided doses twice a day

cefotetan

1-2 g IV or IM every 12hrs for moderate infections
2 g IV every 12hrs for Severe infections
3 g IV every 12hrs for Life-threatening infections
The maximum duration of therapy is 14 days

cefiderocol

Intravenous (IV)

every 8 hrs

7 - 14

days

loracarbef

Uncomplicated- Take 400 mg two times a day for two weeks by oral route

sulfisoxazole

The usual adult dose required for treating this infection is 2 g of oral administration four times daily for 14 days

Dose Adjustments

Not Available

ceftizoxime

The usual dose for the treatment of pyelonephritis is 1 to 2 g via Intravenous or Intramuscular administration two or three times a day for up to 14 days
The duration of the treatment depends on the severity and the nature of the infections

Dose Adjustments

Renal Dose Adjustment
In case of renal insufficiency, the usual dose of ceftizoxime depends on the CrCl. If the CrCl is below 5 mL/min, then 0.25-0.5 g a day or 0.5-1 g via IV or IM in 2 days after undergoing dialysis. Loading dose is standard in renal insufficiency, which is 0.5-1 g. 0.25 -1g twice a day if CrCl falls between 5 and 49 mL/min and 0.5 – 1.5 g thrice a day if CrCl is between 50 and 79 mL/min

tebipenem (Pending FDA Approval)

In the process of receiving FDA clearance for the treatment of acute pyelonephritis

ticarcillin

3g IV every 4 to 6 hours continued for 10 to 14 days

Future Trends