Sandbox/pyelo

Urinary Tract Infections Main Page
Pyelonephritis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Pyelonephritis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocaridogram
X Ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Sandbox/pyelo On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Sandbox/pyelo All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Sandbox/pyelo
CDC on Sandbox/pyelo
Sandbox/pyelo in the news
Blogs on Sandbox/pyelo
Directions to Hospitals Treating Pyelonephritis
Risk calculators and risk factors for Sandbox/pyelo

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]

Empiric Therapy Adapted from Clin Infect Dis. 2011;52(5):e103-20.

Acute Pyelonephritis, Outpatient Preferred Regimen ▸ Ciprofloxacin 500 mg PO q12h x 7 days ± Ciprofloxacin 400 mg IV x 1 dose OR ▸ Ciprofloxacin XR 1000 mg PO q24h for 7 days OR ▸ Levofloxacin 750 mg PO q24h for 5 days PLUS (if fluoroquinolone resistance >10%) ▸ Ceftriaxone 1 g IV x 1 dose OR ▸ Gentamicin 7 mg/kg IV x 1 dose OR ▸ Tobramycin 7 mg/kg IV x 1 dose OR ▸ Amikacin 20 mg/kg IV x 1 dose Alternative Regimen 1 ▸ TMP/SMZ 160/800 mg PO q12h x 14 days PLUS (if TMP/SMZ resistance unknown) ▸ Ceftriaxone 1 g IV x 1 dose OR ▸ Gentamicin 7 mg/kg IV x 1 dose OR ▸ Tobramycin 7 mg/kg IV x 1 dose OR ▸ Amikacin 20 mg/kg IV x 1 dose Alternative Regimen 2 ▸ Amoxicillin–Clavulanate 500/125 mg PO q12h x 14 days OR ▸ Amoxicillin–Clavulanate 250/125 mg PO q8h x 5–7 days OR ▸ Cefaclor 500 mg PO q8h x 7 days PLUS ▸ Ceftriaxone 1 g IV x 1 dose OR ▸ Gentamicin 7 mg/kg IV x 1 dose OR ▸ Tobramycin 7 mg/kg IV x 1 dose OR ▸ Amikacin 20 mg/kg IV x 1 dose

Acute Pyelonephritis, Inpatient Preferred Regimen ▸ Ciprofloxacin 400 mg IV q12h OR ▸ Levofloxacin 750 mg IV q24h Alternative Regimen 1 ▸ Gentamicin 7 mg/kg IV q24h ± Ampicillin 500 mg IV q6h OR ▸ Tobramycin 7 mg/kg IV q24h ± Ampicillin 500 mg IV q6h OR ▸ Amikacin 20 mg/kg IV q24h ± Ampicillin 500 mg IV q6h Alternative Regimen 2 ▸ Cefotaxime 1–2 gm IV q8h OR ▸ Ceftriaxone 1 gm IV q24h OR ▸ Ceftazidime 2 gm IV q8h OR ▸ Ampicillin-Sulbactam 1.5 g IV q6h OR ▸ Piperacillin-Tazobactam 3.375 gm IV q4–6h OR ▸ Ticarcillin-Clavulanate 3.1 gm IV q4–6h WITH OR WITHOUT ▸ Gentamicin 7 mg/kg IV q24h OR ▸ Tobramycin 7 mg/kg IV q24h OR ▸ Amikacin 20 mg/kg IV q24h Alternative Regimen 3 ▸ Meropenem 500 mg IV q8h OR ▸ Ertapenem 1 g IV q24h OR ▸ Doripenem 500 mg IV q8h OR ▸ Aztreonam 1 g IV q8–12h Antibiotics should be administered for at least 10–14 days based on local resistance pattern. Switch to oral formulations 24–48 hours after fever resolution may be considered.