Template:Pyelonephritis antibiotics: Difference between revisions
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''Treatment is targeted at [[E. coli]], [[Enterococcus]], [[Klebsiella]], [[Proteus mirabilis]], [[S. saprophyticus]]'' | ''Treatment is targeted at [[E. coli]], [[Enterococcus]], [[Klebsiella]], [[Proteus mirabilis]], [[S. saprophyticus]].'' | ||
====Outpatient==== | ====Outpatient==== | ||
''Consider one dose of [[Ceftriaxone]] 1g IV or [[Gentamycin]] 7mg/kg IV if the regional susceptibility of [[TMP/SMX]] or [[Fluoroquinolones]] is <80%'' | ''Consider one dose of [[Ceftriaxone]] 1g IV or [[Gentamycin]] 7mg/kg IV if the regional susceptibility of [[TMP/SMX]] or [[Fluoroquinolones]] is <80%'' | ||
*[[Ciprofloxacin]] 500mg PO BID x7 days '''OR''' | *[[Ciprofloxacin]] 500mg PO BID x7 days '''OR''' | ||
*[[Trimethoprim-Sulfamethoxazole DS]] 160/800mg PO BID x14 days '''OR'''<ref>Gupta K, Hooton TM, Naber KG, et al. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women. Clinical Infectious Diseases. 2011;52(5):e103-e120. doi:10.1093/cid/ciq257</ref> | |||
*[[Cephalexin]] 500mg QID PO x 10-14 days (OR consider 1000mg BID if difficulty with QID regimen) '''OR''' | |||
*[[Cefdinir]] 300mg BID PO x 10-14 days '''OR''' | |||
*[[Cefpodoxime]] 200mg PO BID x 10 days '''OR'''<ref>Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitis. Am Fam Physician. 2011 Oct 1;84(7):771-6.</ref> | *[[Cefpodoxime]] 200mg PO BID x 10 days '''OR'''<ref>Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitis. Am Fam Physician. 2011 Oct 1;84(7):771-6.</ref> | ||
*[[Cefixime]] 400mg PO daily x 10 days '''OR'''<ref>Acute Pyelonephritis in Adults. Johnson, JR and Russo, TA. New England Journal of Medicine 2018; 378:48-59.</ref> | *[[Cefixime]] 400mg PO daily x 10 days '''OR'''<ref>Acute Pyelonephritis in Adults. Johnson, JR and Russo, TA. New England Journal of Medicine 2018; 378:48-59.</ref> | ||
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====Adult Inpatient Options==== | ====Adult Inpatient Options==== | ||
*[[Ciprofloxacin]] 400mg IV q12hr '''OR''' | *[[Ciprofloxacin]] 400mg IV q12hr '''OR''' | ||
*[[Ceftriaxone]] 1gm IV QD '''OR''' | *[[Ceftriaxone]] 1gm IV QD <span style="color:red">'''(Preferred in pregnancy)'''</span> '''OR''' | ||
*Cefotaxime 1-2gm IV q8hr '''OR''' | *Cefotaxime 1-2gm IV q8hr '''OR''' | ||
*[[Gentamicin]] 3mg/kg/day divided q8hr +/- [[ampicillin]] 1–2 gm q4hr '''OR''' | *[[Gentamicin]] 3mg/kg/day divided q8hr +/- [[ampicillin]] 1–2 gm q4hr '''OR''' | ||
Latest revision as of 22:37, 21 September 2022
Treatment is targeted at E. coli, Enterococcus, Klebsiella, Proteus mirabilis, S. saprophyticus.
Outpatient
Consider one dose of Ceftriaxone 1g IV or Gentamycin 7mg/kg IV if the regional susceptibility of TMP/SMX or Fluoroquinolones is <80%
- Ciprofloxacin 500mg PO BID x7 days OR
- Trimethoprim-Sulfamethoxazole DS 160/800mg PO BID x14 days OR[1]
- Cephalexin 500mg QID PO x 10-14 days (OR consider 1000mg BID if difficulty with QID regimen) OR
- Cefdinir 300mg BID PO x 10-14 days OR
- Cefpodoxime 200mg PO BID x 10 days OR[2]
- Cefixime 400mg PO daily x 10 days OR[3]
- Levofloxacin 750mg PO QD x7 days[4]
Adult Inpatient Options
- Ciprofloxacin 400mg IV q12hr OR
- Ceftriaxone 1gm IV QD (Preferred in pregnancy) OR
- Cefotaxime 1-2gm IV q8hr OR
- Gentamicin 3mg/kg/day divided q8hr +/- ampicillin 1–2 gm q4hr OR
- Piperacillin/Tazobactam 3.375 gm IV q6hr OR
- Cefepime 2gm IV q8hr OR
- Imipenem 500mg IV q8hr
Pediatric Inpatient Options
- Ceftriaxone 75mg/kg IV QD OR
- Cefotaxime 50mg/kg IV q8hrs OR
- Ampicillin 25mg/kg IV q6hrs + Gentamicin 2.5mg/kg IV q8hrs
- ↑ Gupta K, Hooton TM, Naber KG, et al. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women. Clinical Infectious Diseases. 2011;52(5):e103-e120. doi:10.1093/cid/ciq257
- ↑ Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitis. Am Fam Physician. 2011 Oct 1;84(7):771-6.
- ↑ Acute Pyelonephritis in Adults. Johnson, JR and Russo, TA. New England Journal of Medicine 2018; 378:48-59.
- ↑ Sandberg T. et al. Ciprofloxacin for 7 days versus 14 days in women with acute pyelonephritis: a randomised, open-label and double-blind, placebo-controlled, non-inferiority trial. Lancet. 2012 Aug 4;380(9840):484-90.