Pyelonephritis

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1. Symptoms;

    1. frequency

    2. dysuria

    3. flank pain

    4. fever

    5. CVA tenderness

2. Lab data:

    1. U/C

    2. U/A

    3. B/C

    4. repeat 1 week after treatment as test of cure

3. Treatment

    1. Mild:

        1. Tab ciprofloxacin 500mg bid for 10-14 days

            1. or TMP-SMZ 800/160

    2. Severe cases:

        1. IV line fix

        2. CBC, diff, BUN, Cr, Na, K, BS, B/C, U/A, U/C-antibiogram

        3. Serum 1/3 2/3 1 lit iv q8h

        4. Amp ampicillin 1gr qid

        5. Amp gentamycin 1.5mg/kg/8h

            1. or Amp ceftriaxone 2gr bid

        6. Sonography

        7. if pregnant:

            1. Amp ceftriaxone 2gr bid

            2. then cap cefalexin 500 mg qid for 14 days

        8. Or Darab Hospital Ab regimen

            1. Ciprofloxacin 400mg q12h IV

            2. Meropenem 1gr q12h IV

    3. in prolong or relapsing cases, use sonography and CT scan