Hospitalized Adults: Community-acquired Pyelonephritis

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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

Community-acquired Pyelonephritis 

Enterobacteriaceae (E. coli)

 

Ceftriaxone

1 g IV q24h

OR

Cefazolin 1g IV q8h (VASF only)

OR

Ertapenem 1g IV daily

For severe PCN allergy:

Vancomycin

PLUS ONE OF EITHER:

Gentamicin

OR

Aztreonam ID-R: SFGH 

2 g IV q8h

 

Switch to oral therapy when susceptibilities known and patient stable.

Duration of therapy 7-14 days based on clinical response.