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Nitrofurantoin, trimethoprim-sulfamethoxazole (TMP/SMX), fosfomycin, and pivmecillinam are currently the first-line agents for empiric therapy of simple cystitis. [4] On the other hand, the choice of empiric antimicrobial therapy for pyelonephritis depends on the severity of illness, specific host factors, and the presence of resistant bacteria.
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 ...
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 .
Pyelonephritis is treated more aggressively than a simple bladder infection using either a longer course of oral antibiotics or intravenous antibiotics. [3] Seven days of the oral fluoroquinolone ciprofloxacin is typically used in areas where the resistance rate is less than 10%.
Ciprofloxacin is a fluoroquinolone antibiotic used to treat a number of bacterial infections. [5] This includes bone and joint infections, intra-abdominal infections, certain types of infectious diarrhea, respiratory tract infections, skin infections, typhoid fever, and urinary tract infections, among others. [5]
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]
Amoxicillin–clavulanic acid is a first-line treatment for many types of infections, including sinus infections, and urinary tract infections, including pyelonephritis. This is, in part, because of its efficacy against gram-negative bacteria which tend to be more difficult to control than gram-positive bacteria with chemotherapeutic antibiotics.
As of 2010 it was recommended by the IDSA as a first-line treatment option for catheter-associated urinary tract infections in adults. [16] In combination with metronidazole it is recommended as one of several first-line treatment options for adult patients with community-acquired intra-abdominal infections of mild-to-moderate severity. [17]