What medications are used in third-line inpatient pyelonephritis empiric therapy?

Updated: Nov 04, 2020
  • Author: Mony Fraer, MD, MHCDS, FACP, FASN; Chief Editor: Thomas E Herchline, MD  more...
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Answer

Answer

See the list below:

  • Gentamicin 3 mg/kg/day IV/IM in three divided doses or 7 mg/kg/day pulsed dosing or
  • Tobramycin 3 mg/kg/day IV/IM in three divided doses or 7 mg/kg/day pulsed dosing or
  • Amikacin 10 mg/kg/day IV/IM in three divided doses or 20 mg/kg/day pulsed dosing
  • All of the above can be administered with or without ampicillin 500 mg IM/IV q6h

A study of a hospital program promoting aminoglycosides as empiric treatment of pyelonephritis found that first-line use of aminoglycosides was associated with higher rates of in vitro activity and lower overall mortality compared with non-aminoglycoside antibiotics, and with a comparable rate of acute kidney injury. [4]


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