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Kidney infection (pyelonephritis)    See images

Overview | Symptoms | Treatment | Prevention

Alternative names:

Urinary tract infection - complicated; Infection - kidney; Complicated urinary tract infection; Pyelonephritis

Treatment

The goals of treatment are control (cure) of the infection and reduction of symptoms. Acute symptoms may persist longer than 48 hours after treatment is begun, although usually symptoms get better rapidly.
Also, due to the high mortality rate in the elderly population, and the risk of permanent kidney damage, prompt treatment is recommended.

Initial therapy usually consists of obtaining a urine culture to identify the causative organism, and selecting appropriate antibiotics to treat that infection. However, it may take 3 to 5 days to receive urine culture results. In the interim, you will usually be given a broad spectrum antibiotic that should cover most urinary infections.

MEDICATIONS:
Intravenous (IV) antibiotics may be used initially to control the bacterial infection if your infection is severe or you cannot take antibiotics by mouth. In acute cases of pyelonephritis, you may receive a ten to fourteen day course of antibiotics. Chronic pyelonephritis may require long-term antibiotic therapy. It is imperative that you finish taking the entire course of prescribed antibiotics. Commonly used antibiotics include:

• Sulfa drugs such as sulfisoxazole/trimethoprim
• Amoxicillin
• Cephalosporins
• Levofloxacin and ciprofloxacin

Kidney damage can result from these infections. Also, the elderly, infants, and immunocompromised people are at increased risk for developing sepsis (a severe blood infection). Often, these people will be admitted to the hospital to receive frequent monitoring for potential problems, and to receive IV antibiotics, additional IV fluids and other medications as necessary. In severe cases, a person may be placed in the intensive care unit to receive even more intense monitoring, especially if any cardiac problems are noted.

MONITORING:
Follow-up should include a urine culture at the completion of antibiotic therapy to ensure that bacteria are no longer present in the urine.

Prognosis

Most cases of pyelonephritis resolve without complication after the treatment. However, the treatment may need to be aggressive or prolonged.

Complications

• recurrence of pyelonephritis
• perinephric abscess (infection around the kidney)
• sepsis, can be fatal
• acute renal failure

Call Your Health Care Provider If:

Call your health care provider if symptoms of pyelonephritis are present.

If you have pyelonephritis, call your health care provider if new symptoms develop, especially decreased urine output, persistent high fever, or severe flank pain or back pain.

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