Complicated Upper Tract
Complicated UTI's are classified as patients who are male, with structural disease, immunosuppressed, with a renal or perinephric abscess or prostatitis.
Bottom Line
- Treatment of pyelonephritis is 7 days if a fluoroquinolone (FQ) is used and 14 days with any other antibiotic.
- Treatment can be changed from IV to PO when afebrile x 48h
- The treatment of a renal abscess is drainage.
Pyelonephritis (inpatient)
- Ceftriaxone 1g IV Daily x 14d OR
- Ciprofloxacin 400MG IV BID (or 500MG PO BID) x 7 days
Renal abscess
- Drainage and antibiotics as per pyelonephritis (inpatient) treatment.
Prostatitis
Acute
- TMP/SMX 160/800 MG (1 DS tab) PO BID x 14-28 d OR
- Fluoroquinolone x 14-28d
Chronic
- TMP/SMX 160/800 MG (1 DS tab) PO BID x 6-12 weeks OR
- Fluoroquinolone x 6-12 weeks