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Treatment of xanthogranulomatous pyelonephritis involves antibiotics as well as surgery. Removal of the kidney is the best surgical treatment in the overwhelming majority of cases, although polar resection (partial nephrectomy) has been effective for some people with localized disease.
For the treatment of simple cystitis in children, a five-day oral course of cephalexin is the preferred choice. As for children with suspected pyelonephritis, a ten-day treatment regimen is recommended. In such cases, a third-generation cephalosporin, such as cefdinir, is suggested as an appropriate option.
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. [87]
It also features prominently in treatment guidelines for acute pyelonephritis, complicated or hospital-acquired urinary tract infection, acute or chronic prostatitis, [20] certain types of endocarditis, [21] certain skin infections, [22] and prosthetic joint infections. [23]
In the EU, cefepime/enmetazobactam is indicated for the treatment of complicated urinary tract infections, including pyelonephritis; [2] hospital-acquired pneumonia, including ventilator-associated pneumonia; [2] and the treatment of people with bacteremia that occurs in association with, or is suspected to be associated with, any of the ...
Together with intravenous antibiotics, drainage [8] —either percutaneous or retrograde with a ureteral stent [9] —has become the cornerstone of treatment since the development of ultrasonography and computed tomography (CT) scanning. Drainage offers a great outcome with low rates of morbidity and mortality.
Trimethoprim is NOT a suitable treatment for pyelonephritis. Although it works very well for cystitis when the causative bacterium is susceptible, it cannot work when the kidney is infected in cases of pyelonephritis. This is because it acts to block folic acid synthesis in bacteria. The bloodstream, which supplies the kidney, is a rich source ...
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 ...