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Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Antibiotics for Kidney Infection

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Kidney infection (pyelonephritis) is a serious infection. It commonly follows a bladder infection, as bacteria ascend from the bladder via a ureter to a kidney. It is often unilateral (one-sided, involving a single kidney), but can on occasion affect both kidneys simultaneously. Symptoms may include burning and itching during urination, painful urination, cloudy urine with or without a foul odor, flank or lower-back pain, severe abdominal pain, fever, chills, nausea and vomiting, and weakness. The pain is characterized as aching, and may be markedly momentarily worsened if you punch the victim gently just under the ribs adjacent to the spine on the affected side.

The standard treatment recommendation for treating a kidney infection has been administering an antibiotic(s) for 14 days.  As I will mention below, a shorter course (7 days) of antibiotic(s) may suffice. Antibiotics of choice include: trimethoprim-sulfamethoxazole (one double-strength tablet twice a day), ciprofloxacin (500 mg once or twice a day), norfloxacin (400 mg twice a day), ofloxacin (200 to 300 mg twice a day), lomefloxacin (400 mg once a day), levofloxacin (250 mg once a day), amoxicillin-clavulanate (875/125 mg twice a day), or cefadroxil (500 mg twice a day).

The patient may worsen and may require hospitalization for an intravenous antibiotic(s). Therefore, anyone who is suspected to have a kidney infection should be brought to medical attention immediately if that is feasible.

In an article recently e-published in Lancet entitled “Ciprofloxacin for 7 days versus 14 days in women with acute pyelonephritis: A randomized, open-lable and double-blind, placebo-controlled, non-inferiority trial,” researchers in Sweden concluded that oral ciprofloxacin administered in a dose of 500 mg orally for 7 days was not inferior in outcome to the same drug and dose regimen administered for 14 days. If these results bear out in future studies, it will be good news indeed, because a shorter course of antibiotics will equate with greater convenience and lower cost, and might over time show fewer side effects or perhaps lesser incidence of antibiotic resistance developing in bacteria.

 

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Tags: General Interest

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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