Pyelonephritis is treated with what antibiotics. Why are these substances needed for treatment? Brief characteristics of individual groups of drugs

Treatment inflammatory diseases organs urinary system require attention not only from outside medical worker, but also from the patient’s side, since from the regularity of administration medicines and following all medical recommendations depends on the outcome of the disease. Antibiotics for – key moment therapy that can effectively eliminate inflammation and restore impaired kidney function.

What drugs do doctors prefer to treat acute and chronic pyelonephritis? The main criteria for choosing an antibiotic are the absence of nephrotoxicity and achieving maximum concentration in kidney tissue. Groups of drugs used for inflammation renal tissue:

• fluoroquinolones;
• protected penicillins;
• cephalosporins 3, 4 generations;
• macrolides;
• other synthetic antibacterial agents.

Monural

Monural is a synthetic broad-spectrum antibiotic related to phosphonic acid derivatives. Used exclusively for the treatment of inflammatory kidney diseases and urinary tract. Active substance drug - fosfomycin. Release form – granules for internal use, packaged in 2 and 3 g.

Has a bactericidal effect due to suppression of the first stage of protein synthesis cell wall and due to the inhibition of a specific bacterial enzyme - enolpyruvil transferase. The latter ensures the absence of cross-resistance of monural with other antibiotics and the possibility of its use in case of resistance to antibacterial agents of the main groups.

Ciprofloccin. – fluoroquinolone antibiotic. Treatment of pyelonephritis (including complicated ones) with ciprofloxacin and related drugs is currently the standard of care. The remedy is also effective when both kidneys are involved in the inflammatory process.

The wide degree of activity of the drug is due to its mechanism of action: ciprofloxacin is able to suppress the division of microbial DNA by inhibiting the action of the enzyme DNA gyrase. This disrupts the synthesis of protein components of the bacterial cell and leads to the death of microorganisms. Ciprofloxacin acts both on actively dividing cells and on bacteria that are at rest.

Tavanik

Tavanic is a broad-spectrum antibacterial agent, another representative of the fluoroquinolone group. The active ingredient is levoxacin. The drug is available in the form of tablets 250, 500 mg.

Levofloxacin synthetic origin and is an isomer (levorotatory) of ofloxacin. The mechanism of action of the drug is also associated with blocking DNA gyrase and indirect destruction of the bacterial cell.

Treatment with Tavanik is prohibited in case of severe chronic failure kidneys, in pregnant and lactating women and in pediatric practice.

Amoxicillin is a bactericidal antibiotic from the group of semisynthetic penicillins. Release form: tablets 0.25, 0.5, 1 gram, powder for preparing a suspension, dry substance for preparing injection forms.

Destruction of the cell wall occurs due to inhibition of the synthesis of protein and carbohydrate components of the bacterial cell. Currently, the spectrum of antimicrobial activity of the drug has significantly narrowed due to the production of beta-lactamase enzymes by bacteria, which inhibit the action of penicillins.

You should also remember about the increased cases of individual intolerance and allergic reactions to penicillin drugs.

However, the lack large quantity side effects, hepato- and nephrotoxicity even during long-term use, as well as low cost make amoxicillin the drug of choice in pediatric practice.

Amoxiclav

Amoxiclav is a semi-synthetic combination drug from the penicillin group, consisting of amoxicillin and an inhibitor of beta-lactamase (bacterial cell enzyme) - clavulonate. Available in tablets (250/125, 500/125, 875/125 mg), powder for dilution and parenteral administration(500/100, 1000/200 mg), powder for suspension (treatment in pediatrics).

The mechanism of action of amoxiclav is based on disruption of the synthesis of peptidoglycan, one of the structural components of the bacterial cell wall. This function is performed by amoxicillin. Potassium salt clavulanic acid indirectly enhances the effect of amoxicillin by destroying some beta-lactamases, which typically cause bacterial resistance to antibiotics.

Indications for use of the drug:

• treatment of uncomplicated forms of inflammation of the renal collecting system and urinary tract;
• acute and chronic pyelonephritis in pregnant women (after assessing the risks of impact on the fetus).

Augmentin

Augmentin is another drug that is a combination of semisynthetic penicillin and clavulonic acid. The mechanism of action is similar to Amoxiclav. It is preferable to treat mild and moderate forms of inflammatory kidney diseases in tablet forms. The course of therapy is as prescribed by the doctor (5-14 days).

Flemoklav solutab

Flemoclav Solutab is also combined agent, consisting of amoxicillin and clavulanate. The drug is active against many gram-negative and gram-positive microorganisms. Available in the form of tablets with dosages of 125/31.25, 250/62.50, 500/125, 875/125 mg.

Ceftriaxone is a third generation injectable cephalosporin. Available in powder form for the preparation of solution for injection (0.5, 1 g).

The main effect is bactericidal, due to blocking the production of cell wall proteins of microorganisms. The density and rigidity of the bacterial cell is disrupted and it can be easily destroyed.

The drug has wide range antimicrobial action, including against the main pathogens of pyelonephritis: streptococci of groups A, B, E, G, staphylococci, including aureus, enterobacter, coli and etc.

Ceftriaxone is administered intramuscularly or intravenously. To reduce pain at intramuscular injection it can be diluted in a 1% lidocaine solution. Treatment lasts 7–10 days depending on the severity of kidney damage. After eliminating the symptoms of inflammation and intoxication, it is recommended to continue using the drug for within three days.

Suprax

Suprax is an antibacterial agent from the group of 3rd generation cephalosporins. The active ingredient of the drug is cefixime. Available in the form of capsules 200 mg and powder for suspension 100 mg/5 ml. The drug is successfully used to treat uncomplicated forms of urinary tract and kidney infections (including acute and chronic pyelonephritis). It can be used in pediatrics (from six months of age) and in pregnant women (after assessing all risks). Breast-feeding It is recommended to discontinue it during therapy.

Suprax has a bactericidal effect, which is caused by inhibition of the synthesis of the protein membrane of microbial cells. The product is resistant to beta-lactamases.

Sumamed – effective antibiotic broad spectrum of action from the group of macrolides. The active ingredient is azithromycin. Available in the form of tablets (125, 500 mg), powder for suspension 100 mg/5 ml, powder for infusion 500 mg. The product is highly active and long period half-life, so treatment usually lasts no more than 3-5 days.

Sumamed has a bacteriostatic and bactericidal (in high concentrations) effect. The drug interferes with the synthesis of the 50S protein fraction and disrupts the replication of microbial DNA. Thus, bacterial division stops, and cells lacking protein molecules die.

Azithromycin

Azithromycin is an antibacterial agent from the macrolide group, which has an active substance similar to Sumamed. The mechanism of action of these drugs is identical.

The use of azithromycin is contraindicated in children under 6 months (for suspension) and 12 years (for tablets) and nursing women.

Vilprafen

Vilprafen is another representative of the macrolide group. The active ingredient of the drug is josamycin. Available in the form of 500 mg tablets.

The antibacterial activity of Vilprafen is due to bacteriostatic and mediated bactericidal effect. In addition to the main gram-positive and gram-negative pathogens of pyelonephritis, the drug is effective against many intracellular microorganisms: chlamydia, mycoplasma, ureaplasma and legionella.

Metronidazole

Metronidazole is a synthetic antibacterial agent. It has not only antimicrobial, but also antiprotozoal, antitrichomoniacal, and antialcohol activity. In the treatment of pyelonephritis, it is a reserve drug and is rarely prescribed.

The mechanism of action during treatment with metronidazole is based on the integration active ingredients the drug into the respiratory chain of bacteria and protozoa, disruption of respiratory processes and death of pathogen cells.

It is important to remember that antibiotics for pyelonephritis should be prescribed exclusively by a doctor, depending on the severity, the presence of contraindications, the severity of symptoms and the type of disease (acute or chronic). A properly selected antibiotic will not only quickly relieve pain in the kidney area, urination problems and symptoms of intoxication, but also, more importantly, eliminate the cause of the disease.

For kidney pyelonephritis - this is the main element of the scheme therapeutic treatment infections. This disease is most common among young children preschool age and in women up to 35–40 years old. In the absence of timely and proper treatment the inflammatory process can lead to quite serious consequences which can negatively affect human health.

Briefly about pyelonephritis

Pyelonephritis is characterized by inflammation of the kidney tissue. In this case, the lymphatic and pyelocaliceal systems, as well as blood vessels. Most clear symptoms, manifested in kidney pyelonephritis and indicating an inflammatory process:

• increased body temperature;
• pain in the lumbar region;
• nausea, vomiting;
• if the course of the disease is complicated by the appearance of cystitis, then general symptoms frequent, painful urination is added;
• general weakness.

The above signs are a definite reason to consult a doctor for a diagnosis and subsequent treatment. Treatment of pyelonephritis with antibiotics is prerequisite, guaranteeing the successful destruction of the pathology and the prevention of further relapses.

Causative agents of pyelonephritis

Most common cause the appearance of pyelonephritis are bact, but also the causative agent of the disease can be enterococci, staphylococci, proteus, Pseudomonas aeruginosa, mycoplasma. As practice shows, viral and fungal infections are extremely rare. Therefore, before deciding which antibiotic group should be used to treat the patient, the doctor must determine the type of infectious agents, the condition of the kidneys, and whether there is a dysfunction of the outflow of urine.

Pseudomonas aeruginosa causing inflammation in the kidney

General principles of antibiotic action

Drugs used to treat pyelonephritis must have, first of all, a bactericidal effect in order to destroy pathogenic microflora. They should also prevent reproduction pathogenic microbes. Modern antibacterial agents are fully capable of solving these problems due to their properties.

Antibiotic therapy should be prescribed by a doctor in accordance with the basic requirements, namely:

• content high concentration in urine;
• eliminating toxic effects on the kidneys;
• bactericidal effect against many pathogens;
• when dosing the drug, it is necessary to take into account the condition of the kidneys and the degree of the disease;
• the same activity of the drug at different levels acid-base balance urine.

If after two to three days the patient’s tests do not show positive effect it is necessary to change the treatment regimen and switch to other antibacterial agents.

Types of antibiotics prescribed for pyelonephritis

What antibiotics are used in the treatment of acute and chronic pyelonephritis? The main condition for taking antibiotics in the treatment of infectious inflammatory process is regular monitoring of the patient's condition based on data obtained using laboratory research. Self-treatment pathology can lead to a chronic course of the disease and the occurrence of various complications.

Antibiotics are natural or semi-synthetic medicines, widely used in the treatment of pyelonephritis, they are divided into the following groups:

• penicillins;
• cephalosporins;
• carbapenems;
• monobactams;
• tetracyclines;
• aminoglycosides;
• lincosamines;
• fosfomycin;
• chloramphenicol.

Treatment of pyelonephritis

Penicillin group

This group includes the following drugs - ampicillin, amoxicillin, benzylpenicillin, oxacillin and other drugs. They most effectively influence both gram-negative and gram-positive microflora. They are also used in cases where the etiology of the infection is unknown.

When the causative agent of the disease is staphylococcus, capable of producing penicillinase that is resistant to the action of penicillin, there is a need for combination drugs. For example: penicillin with oxacillin (ampiox) or with β-lactomase inhibitors, these include augmentin (amoxicillin with clavulanate) or unasin (ampicillin and sulbactam).

Carbenicillin and azlocillin are the most effective remedy against Pseudomonas aeruginosa infection.

Cephalosporins have a powerful bactericidal effect against to a wide circle microorganisms. For treatment acute pyelonephritis Third and fourth generation cephalosporins are used.

One of the representatives of the third generation is ceftriaxone. It is prescribed for treatment various forms pyelonephritis, both in combination with other antibiotics and independently. Thanks to its properties, ceftriaxone makes it possible to successfully combat strains of infectious agents that are resistant to other members of the cephalosporin group. Having low toxicity, it can be used to treat weakened patients, as well as the elderly and children. Method of administration: intravenously, in the form of droppers, or intramuscular injections. For children under 12 years of age, ceftriaxone is prescribed in amounts from 20 to 80 mg/kg of human body weight. For adults and older children daily dose is 1–4 g.

To cephalosporins latest generation refers to the drug cefepime. In its properties and characteristics, it is similar to antibiotics such as ceftriaxone and cefotaxime. At the same time, it has increased activity against Pseudomonas aeruginosa, β-lactamases and non-fermenting organisms.

Carbapenems

This group of antibiotics is among the drugs used to treat kidney infections caused by Pseudomonas aeruginosa or enterococci. A medicine in this group includes imipinem, which is used in combination with cilastatin. Imipinem is prescribed in case of severe infection caused by multiple strains of microorganisms.

Monobactams

Drugs belonging to this group have powerful antibacterial properties against gram-negative microflora. Monobactams include Azactam (aztreonam).

Lincosamines

Medicines from the lincosamine group include clindamycin and lincomycin. The activity of these drugs has a narrowly targeted spectrum of activity - gram-positive flora (staphylococci, streptococci). Lincosamines are not effective against enterococci.

Compared with β-lactam antibiotics, aminoglycosides are active against a wider range of pathogens and are more effective and faster antimicrobial actions. But it is necessary to take into account their possible nephrotoxic effect.

Fosfomycin

Fosfomycin is a fairly effective bactericidal antibiotic with a wide spectrum of action. It is successfully used to destroy infectious agents resistant to other antibacterial agents. It is a reserve drug for pyelonephritis, as it is excreted unchanged from the body in the urine.

Levomycetin

Levomycetin is an antibiotic with bacteriostatic properties. Effective in the treatment of kidney infections caused by gram-negative, gram-positive, anaerobic, aerobic bacteria, as well as chlamydia and mycoplasma.

Urine reaction

An important point in the treatment of pyelonephritis is to take into account the patient’s urine reaction. In case of an acid reaction, the effect of antibiotics such as tetracycline, penicillin and novobiocin. increases. With an alkaline reaction, the effect of erythromycin, aminoglycosides, and lincomycin increases. There are also medicines whose effectiveness does not depend on the acidity of the environment - ristomycin, vancomycin and chloramphenicol.

Stages of treatment of pyelonephritis

The treatment regimen for pyelonephritis consists of three stages:

• elimination of the source of inflammation;
• immunocorrective and antioxidant measures;
• anti-relapse therapy.

On initial stage The following groups are indicated for use in the treatment of acute pyelonephritis: antibacterial drugs:

• penicillins in combination with β-lactamase inhibitors - amoxicillin, augmentin, amoxiclav;
• second generation cephalosporins – cefuroxime, cefamandole;
• representatives of the third generation of cephalosporins - cefoperazone, ceftriaxone, ceftazidime;
• aminoglycosides – gentamicin, amikacin.

After removal acute symptoms diseases, the patient may be prescribed the following types of drugs:

• 3rd generation cephalosporins - for example, Cedex;
• penicillins with β-lactamases – augmentin;
• nitrofurans – furadonin;
• quinolans – nitroxoline, nevigramone;
• antioxidant and immunostimulating agents.

To speed up the recovery process, patients are recommended to use vitamin complexes, adaptogens – tinctures Chinese lemongrass or ginseng 20–35 drops up to three times a day throughout the entire treatment period.

At chronic course disease, the duration of anti-relapse therapy for pyelonephritis can last up to a year, with periodic breaks and under the supervision of a doctor.

Video: Antibiotics for pyelonephritis

Antibacterial drugs are included in the standard. Basic Rule- prescribing medications and monitoring therapy under the supervision of a physician.

General principles

1. Inadequate prescription of medications contributes to the development of resistance of the infectious agent and the ineffectiveness of subsequent treatment.
2. Dosages of antibacterial drugs vary depending on the patient's age and the current state of kidney function.
3. Antibiotic therapy is prescribed during inflammation and is possible during anti-relapse therapy. Antibiotics are combined with antibacterial agents from other groups (nitrofurans, herbal medicine).
4. Ideally, it is necessary to prescribe medications to which the microbe’s sensitivity has been established. In practice, the severity of the condition often does not allow waiting for results additional examination sick. An empirical approach is used, drugs are prescribed that act on the most possible causative agents of pyelonephritis or are characterized by a wide spectrum of action.
5. The drugs have significant side effects : allergic reactions, dysbacteriosis and many others.

Medicines used(specific drugs and administration regimens are determined by specialists depending on clinical forms diseases, concomitant condition patient and other factors):

Special aspects of antibiotic therapy

Has a certain influence Urine pH. For norfloxacin, aminopenicillins, nitrofurans, nalidixic acid increased activity V acidic environment(pH<6,0). Для цефалоспоринов, аминогликозидов, карбенициллина, эритромицина, сульфаниламидов, клиндамицина - в щелочной среде.

For renal failure, it is safe to prescribe doxycycline, azithromycin, chloramphenicol, pefloxacin, cefoperazone, cefaclor, erythromycin at the usual dose. This requires monitoring liver function as they are metabolized there.

Efficiency Antibacterial therapy is assessed according to the following criteria:

1. Early(48-72 hours after the first administration of the antibiotic). Reducing temperature, signs of intoxication (weakness, nausea, headaches), improving subjective well-being and kidney function; the appearance of sterile urine (according to laboratory tests), more often after 3-4 days from the start of therapy.
2. Late(14-30 days from the start of treatment). No recurrence of fever or chills within 2 weeks after completion of antibiotic therapy; achieving negative urine test results for bacteria, usually 3-7 days after completion of antibacterial therapy.
3. Final(after 1-3 months). If there are no recurrent urinary tract and kidney infections within 12 weeks after the end of antibiotic therapy.

Simultaneously into a complex treatment regimen for the disease turn on anti-inflammatory therapy, detoxification treatment (plasma, glucose-saline solutions), heparin, small doses of diuretics.

After eliminating acute inflammation and removing microbes, antibiotics are replaced with antibacterial agents plant origin(For example, Canephron).

In case of repeated treatment is in frequent changes of antibacterial drugs(in 7-10 days). For example, sequential assignment ampicillin - erythromycin - cephalosporins - nitrofurans. Under control (bacteriuria, leukocyturia).

Repeated courses Antibiotic therapy is often necessary in the next 3-4 months against the background of relapse of the disease.

Pyelonephritis is a very insidious kidney disease that can occur in both adults and young children. It is dangerous because it is often asymptomatic, which is why the patient is unaware of the presence of the disease. Meanwhile, the pathology gradually develops into a chronic form, which is very difficult to combat. However, modern medicine does not stand still, and today there are a lot of medicines that can be used to get rid of kidney pyelonephritis in the shortest possible time.

Groups of antibiotics and their features

To treat pyelonephritis in adults and young patients, regardless of the form of the disease (acute or chronic), antibacterial drugs are most often used. However, it is strictly not recommended to take them without a doctor’s prescription - almost all antibiotics can cause serious side effects if they are selected or used incorrectly. In addition, antimicrobial drugs are classified into groups, and which of them will be effective in each specific case can be found out only after bacterial culture.

The following groups of antibiotics are often prescribed for the treatment of pyelonephritis in children and adults, such as:

Throughout the entire period of treatment of pyelonephritis with drugs containing an antibiotic, it is necessary to adhere to a certain regimen.

It is aimed at speedy recovery of the body after the disease, and will also reduce the negative impact of the antibacterial drug on the intestines.

To do this, you need to try to avoid hypothermia, exclude all heavy and harmful foods, coffee and strong tea from your diet. Thus, it is possible to significantly reduce the negative load on the stomach and liver, which will help these organs more easily tolerate the influence of the active substances that make up a particular antibiotic.

Effective antibacterial drugs to get rid of pyelonephritis

Antibiotics for pyelonephritis should be used for therapeutic purposes very carefully, even if they were prescribed by a doctor. Such drugs have their own indications and contraindications for use, which you need to know about. Let's look at the most commonly used antibiotics for the treatment of pyelonephritis.

Amoxicillin for pyelonephritis

Amoxicillin is an antibiotic of the penicillin group, available in tablets. It is used not only for pyelonephritis, but also for the treatment of diseases of the genitourinary system such as:

• urethritis;
• gonorrhea;
• gynecological diseases;
• leptospirosis, etc.

For the treatment of pyelonephritis in women and men, Amoxicillin is best used together with clavulanic acid.

Contraindications to the use of Amoxicillin in acute pyelonephritis are:

Amoxicillin should be used with caution for pyelonephritis in children under 10 years of age. The dosage and duration of therapy depends on several factors:

• severity of the disease;
• age category of the patient;
• individual characteristics of the body;
• possible risks of side effects.

The use of the drug for the treatment of pyelonephritis can also provoke a number of side effects, among which the most common are the following:

If Amoxicillin is used together with Metronidazole, the patient may experience the following side effects:

• nausea, sometimes vomiting;
• diarrhea;
• constipation;
• dysbacteriosis;
• stomatitis.

Amoxicillin is a broad-spectrum antibiotic of the latest generation, due to which the maximum effect of its use is achieved for kidney pyelonephritis and other diseases of the genitourinary system. The main thing is to follow the treatment regimen developed by your doctor.

Cephalexin for the treatment of pyelonephritis

Treatment of pyelonephritis with cephalosporin antibiotics is carried out under the close supervision of physicians, especially when it comes to young patients. This drug can cause serious side effects, although it is considered relatively easy for the body to absorb.

The drug is available in the form of capsules and tablets, and only with a prescription. It is used to treat various diseases of the urinary and genitourinary system of a bacterial nature.

Contraindications for use:

1. Capsules or tablets should be used with caution for the treatment of pyelonephritis in children under 3 years of age (for children, the drug is dispensed in the form of a suspension).
2. Individual intolerance to substances included in the antibiotic.
3. Kidney failure.
4. Pregnancy and lactation.

Cephalexin suspension should not be given to an infant under six months of age. What antibiotics can be given to newborns who have been diagnosed with pyelonephritis can only be decided by a pediatric urologist (in extreme cases, a neonatologist).

For adults, the daily dose of Cephalexin capsules or tablets is 250-500 mg. The number of receptions per day is 3-4 times. The dose of the drug for children is several times lower – from 25 to 50 mg/kg per day. In case of severe disease, the daily dosage of medication for adults can be increased by a maximum of 4 times. The same scheme applies to children, only their dose directly depends on their body weight. The course of treatment is 7 days.

No matter what antibiotics are used to treat pyelonephritis, these drugs, without exception, can cause side effects. While taking Cephalexin, patients may complain of:

These are not all the side effects that the drug can cause, but only the most common ones. However, if you strictly follow the doctor’s recommendations, you should not experience any abnormalities.

Cephalexin shows good results in the fight against pyelonephritis and other kidney diseases. If the patient completes a full course of treatment, the risk of relapse of the disease will significantly decrease.

Antibiotic Amikacin

Amikacin is an antimicrobial drug of the aminoglycoside group. Widely used to treat diseases of the urinary system, including:

1. Pyelonephritis (acute or chronic).
2. Cystitis.
3. Urethritis.

This drug is a broad-spectrum antibiotic, so it is used to treat many other pathologies. The medicine is used with caution in infants, as well as for the treatment of pyelonephritis in elderly patients. Contraindications to injections may include:

1. Pregnancy period.
2. Breast-feeding.
3. Acoustic neuritis.
4. Chronic renal failure, which occurs in severe form and with certain complications.
5. Increased sensitivity of the body to the drug.

The drug is intended for intramuscular or intravenous (drip) administration. The duration of the procedure is up to 2 minutes (jet). In case of exacerbation of chronic pyelonephritis, or in the treatment of its acute form, the patient is administered 250 mg of the drug every 12 hours. The duration of treatment depends on the severity of the pathology, as well as the age of the patient.

Side effects from using Amikacin may include:

Despite the rather extensive list of side effects, you should not think that they occur all the time. Most patients, as a rule, easily tolerate therapy based on the use of Amikacin. In addition, the medicine gives fairly good results in the treatment of pyelonephritis, both in adults and children. Although, of course, the healing process directly depends on the functioning of the human immune system, as well as the severity of the pathology.

Levofloxacin in the fight against pyelonephritis

Levofloxacin is a tablet antibiotic of the fluoroquinolone group, used to treat diseases of the urinary system, in particular:

• acute pyelonephritis;
• chronic prostatitis.

This is a potent, broad-spectrum drug that must be used with extreme caution. Despite the fact that the effect of therapy is achieved quite quickly, this medicine is strictly prohibited for use if:

In addition, the drug should be used with caution in children and adolescents due to its negative effect on joints. Elderly people are also at risk of developing severe complications after such therapy.

The drug is intended exclusively for oral administration. Tablets are taken 1-2 times a day. As a rule, for pyelonephritis, the antibiotic is taken in a dosage not exceeding 250 mg at a time. The course of therapy lasts from 7 to 10 days. The medicine does not need to be chewed, it should be washed down with water. The tablets can be taken before meals or between meals.

If we compare Levofloxacin with other antibiotics used to treat pyelonephritis, it is important to note that it can cause many more side effects. Among them, the most common ones should be noted:

Important! To avoid serious complications, under no circumstances should you self-prescribe this or that antibiotic.

You can never know for sure whether a person is allergic to a drug, since this can only be determined after special manipulation - allergy tests. Until this is done, it is better to entrust the issue of treating pyelonephritis to a qualified specialist - a urologist.

Pyelonephritis is one of the most common kidney diseases for which people consult a doctor. This disease is caused by pathogenic microflora that enters the patient’s body from the bladder or through the bloodstream. It is for this reason that the disease should be treated by a highly qualified doctor who will individually prescribe the most effective and safe antibiotics for pyelonephritis. In the absence of adequate therapy, pyelonephritis can have adverse consequences for the patient's future life.

Briefly about pyelonephritis

Pyelonephritis is a kidney disease of inflammatory origin, which can occur both as a primary and as a secondary lesion. Most often, the primary form of the disease is characteristic of acute pyelonephritis. The secondary form is a disease that develops as a complication of other pathologies. Most susceptible to this disease are:

• school-age and teenage children;
• women of childbearing age;
• men suffering from pathologies of the genitourinary system (adenoma, prostatitis).

The following symptoms may indicate the presence:

• pain in the lumbar region;
• change from the usual straw-yellow color of urine to greenish or red;
• attacks of nausea;
• general weakness and malaise;
• chills and increased body temperature;
• increased heart rate and breathing.

When the first alarming symptoms appear, you must seek qualified medical help and under no circumstances self-medicate.

Features of antibacterial treatment of inflammatory kidney diseases

Considering the bacterial origin of the disease, pyelonephritis must be treated with antibiotics. To accurately determine which drugs should be used to treat the disease, it is recommended to do a bacterial culture of urine to determine the sensitivity of the microflora to the antibiotic. In order not to waste time waiting for the results of bacterial culture, the attending physician may prescribe one of the broad-spectrum antibiotics for the treatment of pyelonephritis.

Most often used:

• piperacillins are a series of modern antibiotics for the treatment of pyelonephritis, belonging to the fifth generation, presented in the pharmacy chain under the names Isipen, Picillin, Piprax;
• penicillins - semi-synthetic drugs of the penicillin group, which are used in the treatment of inflammatory processes of the urinary system in the form of tablets or powders for injection, known as Ampicillin, Penodil, Zetsil;
• cephalosporins - modern fourth-generation drugs that have a wide spectrum of action, are presented in the pharmacy chain in the form of a solution for intravenous or intramuscular administration Cephanorm, Tsepin, Cefomax;
• fluoroquinolones are third and fourth generation antibacterial drugs that are rarely used to treat inflammatory processes in urology due to the high toxicity of the drug (Norfloxacin, Levofloxacin, Moxifloxacin);

• beta-lactams are one of the most effective drugs for antibacterial therapy, intended for intravenous administration Meropenem, Doriprex;
• chloramphenicol is a large group of antibiotics, the active substance of which is chloramphenicol, these are the drugs Nolicin, Otomycin, Marmacetin.

For pyelonephritis, drugs such as Gentamicin, Amikacin can be prescribed, which give a good anti-inflammatory effect, but have a large number of side effects, including partial or complete hearing loss. Used in exceptional cases.

Broad-spectrum antibiotics are always prescribed by doctors with extreme caution, since they do not have a selective effect and affect all microorganisms. When choosing from a large list of drugs for pyelonephritis, the doctor will choose an antibiotic that will meet the following requirements:

• have minimal toxic effects on the patient’s body;
• have a pronounced antibacterial effect;
• combined with other complex treatment drugs;
• is excreted from the body mainly with urine.

To evaluate the correct treatment, nephrologists use early and late criteria, which include:

• reduction and normalization of body temperature;
• there are no symptoms of intoxication;
• normalization of kidney function;
• improvement of clinical indications;
• no pain in the kidneys and lower back.

The most informative and important criterion for a correctly selected antibiotic for the treatment of pyelonephritis is the absence of relapse of the disease for three months after an acute attack.

When treating an acute form of the disease, you need to know which antibiotics will be most effective for this type of pyelonephritis. The choice of drug directly depends on the type of pathogen:

• if the disease is caused by E. coli, then the most effective will be aminoglycosides, fluoroquinolones and cephalosporins, which are prescribed in a 7-10-day course;
• when identifying a pathogenic microorganism such as Proteus, it is advisable to use Gentamicin, Nitrofuran, Ampicillin;
• when affecting the kidneys with enterococcus, it is recommended to combine Gentamicin with Ampicillin, or Vancomycin with Levomycetin.

When treating acute pyelonephritis, it is recommended to treat the disease in a hospital setting, under the close supervision of the attending physician. All antibacterial drugs are recommended to be taken parenterally, in the form of intravenous or intramuscular injections, to more quickly achieve a therapeutic effect.

Features of the use of antibacterial drugs

Complex treatment of pyelonephritis is aimed at:

• suppression of the inflammatory process in the kidneys;
• pathogenetic effects;
• preventive anti-relapse treatment;
• immunocorrection after a course of antibiotic therapy.

To suppress the inflammatory process, Ceftriaxone is prescribed 1 g intramuscularly or intravenously, the course duration is 7-10 days. Intravenous injections of Gentamicin at the rate of 3-5 mg per 1 kg of weight. Augmentin is prescribed in tablet form at a dose of 500 mg 3 times a day. Another modern and highly effective drug for pyelonephritis that can be used by children and pregnant women is Flemoklav Solutab. This is a semi-synthetic antibiotic that meets all the requirements of the drug for antibacterial therapy. Adults are prescribed 625 mg 3 times a day.

After a course of antibiotic therapy, which lasts 7-10 days, it is recommended to take anti-relapse drugs. For this purpose, Biseptol, Nitroxoline or 5-NOK are prescribed. To correct the immune system, immunomodulatory drugs are prescribed, which must be prescribed by an immunologist. A safe remedy to strengthen your immune system and support your kidneys after antibiotics is to drink herbal kidney tea.

All drugs for complex treatment of pyelonephritis must be prescribed individually by the attending physician, taking into account the severity of the disease, the general health of the patient, as well as the type of causative agent of the disease.

Possible complications

With long-term use of antibiotics, a number of side effects and complications may develop:

• toxic effects on the kidneys, liver and other organs;
• dyspeptic disorders from the gastrointestinal tract;
• individual intolerance to the drug or its components;
• development of fungal infection;
• complications in the form of an abscess, hematoma, phlebitis due to improper parenteral administration of the drug, etc.

With the correct selection of the drug, treatment under the supervision of a doctor and medical personnel, monitoring of clinical blood and urine parameters, the risk of complications is minimized. At the same time, the patient has every chance of complete recovery from the disease and prevention of repeated exacerbations.