Adult Outpatients: Urinary Tract Infections: Pyelonephritis

PrintPrintPDFPDF

Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Pyelonephritis 

Enterobacteriaceae (E. coli)

Enterococci

Ciprofloxacin 500 mg PO BID X 7-14 days

OR

LevofloxacinID-R: VASF 500 mg PO daily X 7-14 days

OR

Trimethoprim/ Sulfamethoxazole 1 DS tablet PO BID X 14 days

PLUS

Ceftriaxone 1 g IV X 1 dose

Cephalexin 500 mg PO QID X 10-14 days

OR

Cefpodoxime 200 mg PO BID X 10-14 days

EITHER OF ABOVE PLUS:

Ceftriaxone 1 g IV X 1 dose

Urine analysis and urine culture should be performed and therapy adjusted based on culture and sensitivity.

 

Trimethoprim-sulfamethoxazole is preferred if organism is susceptible.

 

Consider a single intravenous dose of ceftriaxone prior to fluoroquinolone therapy if patient is at high risk for fluoroquinolone-resistant organisms.