Patient Education for Pyelonephritis
Understanding Your Kidney Infection
You have pyelonephritis, which is a bacterial kidney infection that requires antibiotic treatment for 5-14 days depending on the specific medication prescribed. 1, 2
- The infection is most commonly caused by E. coli bacteria (75-95% of cases), which typically travels from your bladder up to your kidneys 2, 3
- Your doctor should have obtained a urine culture before starting antibiotics to ensure the bacteria causing your infection is susceptible to the prescribed medication 1, 2
Your Antibiotic Treatment Plan
If You're Being Treated at Home (Outpatient)
The most common outpatient treatment is oral ciprofloxacin 500 mg twice daily for 7 days, or levofloxacin 750 mg once daily for 5 days. 1, 2
- If you live in an area where antibiotic resistance is high (>10%), you may have received a one-time IV dose of ceftriaxone or gentamicin before starting oral antibiotics 1, 2
- Alternative options include ciprofloxacin 1000 mg extended-release once daily for 7 days 1, 2
- If your bacteria is confirmed susceptible to trimethoprim-sulfamethoxazole (Bactrim), you may take this twice daily for 14 days 1, 2
- Beta-lactam antibiotics (like amoxicillin or cephalexin) require 10-14 days of treatment if prescribed 1, 2
If You're Being Treated in the Hospital (Inpatient)
- You will receive IV antibiotics initially, which may include fluoroquinolones, aminoglycosides with or without ampicillin, extended-spectrum cephalosporins, or carbapenems 1, 2, 4
- Once you've been fever-free for 48 hours and can tolerate oral intake, your doctor will likely switch you to oral antibiotics based on your culture results 4
Critical Warning Signs - When to Seek Immediate Care
Return to the emergency department or call your doctor immediately if you experience: 4, 3
- No improvement in fever or symptoms after 48-72 hours of antibiotics 4
- Worsening fever, chills, or shaking 3
- Persistent vomiting that prevents you from taking oral medications 3
- Confusion or altered mental status 4
- Severe back or flank pain that worsens 3
- Blood in your urine that wasn't present before 3
What to Expect During Treatment
- Most patients improve within 48-72 hours of starting appropriate antibiotics 4, 5
- Fever should resolve within 2-3 days of treatment 5
- If you don't improve after 72 hours, imaging studies (CT scan) may be needed to check for complications like kidney abscesses 4
Important Instructions for Taking Your Antibiotics
Complete the entire course of antibiotics even if you feel better after a few days. 3, 6
- Take your medication at the same times each day to maintain consistent levels in your bloodstream 7
- Do not skip doses or stop early, as this can lead to treatment failure and antibiotic resistance 1, 6
- If you're taking fluoroquinolones (ciprofloxacin or levofloxacin), avoid taking them with dairy products, antacids, or supplements containing calcium, magnesium, iron, or zinc, as these can interfere with absorption 7
Follow-Up Care
- Your doctor should repeat a urine culture 1-2 weeks after completing antibiotics to confirm the infection has cleared 3
- If you have recurrent kidney infections, you may need imaging studies to check for underlying anatomic abnormalities 3, 5
Preventing Future Kidney Infections
- Stay well-hydrated by drinking 6-8 glasses of water daily 3
- Urinate when you feel the urge; don't hold it for long periods 3
- For women: wipe from front to back after using the bathroom 3
- Urinate shortly after sexual intercourse 3
Special Considerations
- If you're pregnant: Only certain antibiotics are safe during pregnancy, and your treatment plan will be specifically tailored 8
- If you have diabetes or chronic kidney disease: You're at higher risk for complications and may require more aggressive initial treatment 4
- If you're elderly: Your doctor will monitor you more closely for side effects, particularly if prescribed aminoglycosides or fluoroquinolones 2