ÎTMP-SMX DS
for 14 days is an appropriate choice for
therapy if the uropathogen is known to be susceptible (A-I). If TMP-SMX is used when the susceptibility is not known, an initial IV dose of a long-acting parenteral antimicrobial such as 1 g ceftriaxone (B-II) or a consolidated 24-hour dose of an aminoglycoside is recommended (B-III).
ÎOral β-lactam agents are less effective than other available agents for treatment of pyelonephritis (B-III). If an oral
β-lactam agent is used, an initial IV dose of a long-acting parenteral antimicrobial such as 1 g ceftriaxone (B-II) or a consolidated 24-hour dose of an aminoglycoside is recommended (B-III).
> Note: Data are insufficient to modify the previous guideline recommendation for a duration of therapy of 10-14 days for treatment of pyelonephritis with a β-lactam agent.
ÎWomen with pyelonephritis requiring hospitalization should be initially treated with an IV antimicrobial regimen such as a fluoroquinolone, an aminoglycoside with or without ampicillin, an extended-spectrum cephalosporin or extended- spectrum penicillin with or without an aminoglycoside, or a carbapenem. The choice between these agents should be based on local resistance data, and the regimen should be tailored based on susceptibility results (B-III).
bid
