MedBalans

Pyelonephritis

Adults · verify locally

Inpatient / outpatient

First line

  • Ciprofloxacin (if local resistance low) · p.o./i.v.

    500–750 mg PO bid (or 400 mg IV bid)

  • Ceftriaxone · i.v.

    1–2 g IV daily (often bridge then oral step-down)

Alternatives

  • TMP-SMX · p.o.

    1 DS PO bid (if susceptible)

  • Piperacillin/tazobactam or carbapenem · i.v.

    Per severity / ESBL risk

Duration

5–7 days (FQ) to 7–14 days depending on agent/response

  • • IDSA pyelonephritis (2011)