How is pyelonephritis treated in males?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Most patients with pyelonephritis should undergo imaging studies to rule out other lesions, and IV antibiotic treatment should be initiated empirically with an aminoglycoside and ampicillin. Third- and fourth-generation cephalosporins, a carbapenem, or aztreonam also provides broad gram-negative rod coverage.

Fluid resuscitation is important if the blood pressure is unstable or if the patient is very old.

IV antibiotics are usually continued until the patient is afebrile for 24 hours, and then oral therapy is prescribed to complete at least 14 days of treatment; 30 days of treatment are typically necessary, because most cases are due to chronic prostatitis.


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