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People with acute pyelonephritis that is accompanied by high fever and leukocytosis are typically admitted to the hospital for intravenous hydration and intravenous antibiotic treatment. Treatment is typically initiated with an intravenous fluoroquinolone, an aminoglycoside, an extended-spectrum penicillin or cephalosporin, or a carbapenem ...
[45] [46] Second-line therapy should be considered for patients who have poor response to first-line treatment. Alternative choices include amoxicillin-clavulanate, nitrofurantoin, TMP/SMX, and ciprofloxacin. [44] For the treatment of simple cystitis in children, a five-day oral course of cephalexin is the preferred choice.
These drugs were widely used as a first-line treatment for many infections, including very commons ones such as acute sinusitis, acute bronchitis, and uncomplicated UTIs. [85] Reports of serious adverse events began emerging, and the FDA first added a black-box warning to fluoroquinolones in July 2008 for the increased risk of tendinitis and ...
Fosfomycin can be used as an effective treatment for both UTIs and complicated UTIs including acute pyelonephritis. [87] The standard regimen for complicated UTIs is an oral 3g dose administered once every 48 or 72 hours for a total of 3 doses or a 6 grams every 8 hours for 7 days to 14 days when fosfomycin is given in IV form.
Uses of nitrofurantoin include the treatment of uncomplicated urinary tract infections (UTIs) and prophylaxis against UTIs in people prone to recurrent UTIs. [9] It is a first-line therapy for acute uncomplicated cystitis. [21] It is not recommended for empiric treatment of hospital-acquired UTIs. [21]
Cefepime/enmetazobactam, sold under the brand name Exblifep, is a medication used for the treatment of urinary tract infections. [1] [2] It is a fixed dose combination containing cefepime, a cephalosporin antibacterial; and enmetazobactam, a beta-lactamase inhibitor.
Similarly, ciprofloxacin is not recommended as a first-line treatment for acute sinusitis. [28] [29] Ciprofloxacin is approved for the treatment of gonorrhea in many countries, but this recommendation is widely regarded as obsolete due to resistance development. [30] [31] [32]
In the United States it is also indicated for the treatment of complicated urinary tract infections including pyelonephritis. [5] [7] [10] It is a potential effective alternative treatment for ceftriaxone-resistant gonorrhoea. [11] [12] It is given as an intravenous infusion or intramuscular injection. The drug is not approved for children ...