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Kidney infection (pyelonephritis)

Overview Symptoms Treatment Prevention

Alternative Names:

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

Treatment:

The goals of treatment are control of the infection and reduction of symptoms. Acute symptoms usually resolve within 48 to 72 hours after appropriate treatment.

Due to the high mortality rate in the elderly population and the risk of permanent kidney damage, prompt treatment is recommended.

After obtaining a urine culture to identify the bacteria, antibiotics are selected to treat the infection.

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 10- to 14-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 the following:

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

Kidney damage can result from these infections. The elderly, infants, and people with a compromised immune system 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.

MONITORING:
In diabetic patients and pregnant women, as well as in people with spinal paralysis, follow-up should include a urine culture at the completion of antibiotic therapy to ensure that bacteria are no longer present in the urine.

Expectations (prognosis):

Most cases of pyelonephritis resolve without complication after the treatment. However, the treatment may need to be aggressive or prolonged. If sepsis (widespread blood infection) occurs, it can be fatal.

Complications:

Recurrence of pyelonephritis
Perinephric abscess (infection around the kidney)
Sepsis
Acute renal failure

Calling your health care provider:

Call your health care provider if symptoms suggesting pyelonephritis occur.

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.