MedBalans

Renal / perinephric abscess

Adults · verify locally

Inpatient

First line

  • Piperacillin/tazobactam or ceftriaxone · i.v.

    Pip/tazo 4.5 g IV q6–8h; or ceftriaxone 1–2 g IV daily

Alternatives

  • Ciprofloxacin / levofloxacin · i.v./p.o.

    If susceptible; step-down after culture

  • Ertapenem / meropenem · i.v.

    Ertapenem 1 g daily; or meropenem if critically ill / ESBL

Duration

Often 2–4 weeks after drainage (longer if incomplete drainage)

Notes

  • Image-guided drainage for larger collections; relieve obstruction.
  • Prolonged antibiotics after source control.

Urine and blood cultures before antibiotics; aspirate culture when drained.

  • • IDSA / urologic abscess practice (2011)