Pyelonephritis
- Ciprofloxacin (20-30mg/kg/d PO/IV div bid) should be reserved for treatment of pyelonephritis due to P. aeruginosa or other multi-drug resistant organisms with documented susceptibility.
- Nitrofurantoin should NOT be used for pyelonephritis or urosepsis as poor renal tissue and serum concentrations.
Usual Pathogens
E. coli
Other Enterobacterales
Enterococcus spp
Infants < 1 month
| Empiric Therapy | Duration | |
|---|---|---|
| Ampicillin | 200mg/kg/d IV div q6h | 7-10 days |
| + | ||
| Gentamicin | 4-5mg/kg IV q24h |
Alternative
| Empiric Therapy | Duration | |
|---|---|---|
| Ampicillin | 200mg/kg/d IV div q6h | |
| + | ||
| Cefotaxime | 100mg/kg/d IV div q8h |
Children > 1 month old
Oral
| Empiric Therapy | Duration | |
|---|---|---|
| Cefixime | 8mg/kg/d PO div q12-24h |
Alternative
| Empiric Therapy | Duration | |
|---|---|---|
| TMP/SMX | 6-12mg TMP/kg/d PO div bid | |
| or | ||
| Amoxicillin-clavulanate | 40mg/kg/d PO div tid |
Parenteral
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ceftriaxone | 50mg/kg IV q24h | |
| or | ||
| Gentamicin | 5-7mg/kg IV q24h |