Medication Summary
Start treatment of pyelonephritis with a broad-spectrum intravenous antibiotic, which is modified according to sensitivities. Continue until the patient has been afebrile for 48 hours and the WBC count has normalized, at which time therapy can be switched safely to oral therapy.
Antibiotic agents
Class Summary
These agents are used to treat pyelonephritis. Conventional treatment typically is initiated with a second-generation intravenous cephalosporin (eg, cefotaxime). Antibiotic regimens are adjusted later according to culture and sensitivities.
Cefotaxime (Claforan)
Third-generation cephalosporin with gram-negative spectrum. Lower efficacy against gram-positive organisms. Arrests bacterial cell wall synthesis, which, in turn, inhibits bacterial growth.
Ampicillin (Marcillin, Omnipen, Polycillin, Principen, Totacillin)
Usually used in combination with an aminoglycoside. Increased resistance to Escherichia coli is beginning to emerge. Exerts bactericidal activity against susceptible organisms.
Gentamicin (Garamycin, Gentacidin)
Aminoglycoside antibiotic for gram-negative coverage. Used in combination with both an agent against gram-positive organisms and one that covers anaerobes.