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Old 05-28-2014
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Default Question about pyelonephrits

MTB says Quinolones are best initial therapy for pyelonephrirs on pg 27 then on the next page it says ceftriaxone is first for pyelonephrits.
Can someone please clear this up for me....Ive about had it with this book.
Thanks in advance
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Old 05-29-2014
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Quote:
Originally Posted by fixer View Post
MTB says Quinolones are best initial therapy for pyelonephrirs on pg 27 then on the next page it says ceftriaxone is first for pyelonephrits.
Can someone please clear this up for me....Ive about had it with this book.
Thanks in advance
ceftriaxone is for neisseria... i
think
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Old 05-29-2014
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initial Tx should be with
ceftriaxone (has a good gram negative coverage and if it is one of the the choices go with it)
amp+gent combo is good as well
followed by oral antibiotics (cipro)
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Old 05-30-2014
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Quote:
Originally Posted by fixer View Post
MTB says Quinolones are best initial therapy for pyelonephrirs ... then on the next page it says ceftriaxone is first for pyelonephrits.
Lets review in short all urinary tract infections "together". Why? Because it caused mostly by same bugs and you know most common gram negative bugs.
Most common thеre is ASCENDING infection , other infections caused by stones, anatomid abnormality etc it is called "COMPLICATED" : cystitis -> pyelonephritis -> abscess. In the other worlds we try to kill same bacterias in all three causes.

Cystitis: TMP/SMX 3 days. But we extended up to 7 days TMP/SMX or use cypro or levofloxacin in complicated infection (see above) or if there is resistent bacteria to TMP/SMX

Pyelonephritis (MC same bacteria but "more serious"): any drugs effective against gram-negative Ciprofloxacin recommended as first choice mostly for outpatients and for inpatients we can use ampicillin or gentamicin. But don't treat all patients with cipro because there can be pregnant or breast feeding mother etc

Abscess: fluoroquinolones and you have to add something for staph, don't forget drainage.

P.S. Urinary tract inf in women is "usual" (if not recurrent) you know bc there is short urethra... but in men it is "strange" so don't forget try to find cause in men (by scanning etc).

Hope it helps little bit.
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Last edited by deyneko; 05-30-2014 at 06:21 AM.
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