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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.
Nitrofurantoin, sold under the brand name Macrobid among others, is an antibacterial medication of the nitrofuran class used to treat urinary tract infections (UTIs), although it is not as effective for kidney infections. [16] It is taken by mouth. [16] Common side effects include nausea, loss of appetite, diarrhea, and headaches. [16]
Symptoms of a kidney infection, on the other hand, are more systemic and include fever or flank pain usually in addition to the symptoms of a lower UTI. [10] Rarely, the urine may appear bloody. [7] Symptoms may be vague or non-specific at the extremities of age (i.e. in patients who are very young or old). [1] [11]
Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. [3] Symptoms most often include fever and flank tenderness. [2] Other symptoms may include nausea, burning with urination, and frequent urination. [2] Complications may include pus around the kidney, sepsis, or kidney failure. [3]
Clinical symptoms in patients with pyonephrosis can range from frank sepsis (15%) to asymptomatic bacteriuria. Upon physical examination, the hydronephrotic kidney may be linked to a palpable abdominal mass . [ 4 ]
β-Lactam antibiotics are indicated for the prevention and treatment of bacterial infections caused by susceptible organisms. At first, β-lactam antibiotics were mainly active only against gram-positive bacteria, yet the recent development of broad-spectrum β-lactam antibiotics active against various gram-negative organisms has increased their usefulness.
The aim of treatment is to reduce renal scarring. Those children with grade II or worse should receive low dose prophylactic antibiotics (Nitrofurantoin, trimethoprim, cotrimoxazole, cefalexin in those with CRF). Hypertension should be managed with ACE inhibitor or ARBs. Other treatment modalities include surgery (endoscopic injection of ...
Includes information found online including these sites: "Indiana University Department of Medicine Clinical Pharmacology Drug Interactions Flockhart Table ™".