Picking The Right Antibiotic: Acute Pyelonephritis During Pregnancy

OVERVIEW

This page is dedicated to providing a practical guide to how one should pick the correct antibiotic(s) to use in the setting of acute pyelonephritis during pregnancy.

WHAT IS ACUTE PYELONEPHRITIS DURING PREGNANCY?

We use the following features to try and define what exactly this condition is:

  • Pregnant patient: this is of course in the setting of pregnancy
  • Clinical signs: flank pain, nausea/vomtiing, fever, CVA tenderness.
  • Cystitis symptoms: such as dysuria/frequency may or may not be present.
WHAT ARE OUR TREATMENT OPTIONS?

For acute management:

  • Hospitalization: patients in this category will be admitted for amangement
  • IV antibiotics: beta-lactams, meropenum

After afebrile for 24 hours:

  • Oral antibiotics: 10-14 day course
WHAT SHOULD BE AVOIDED?

The following antibiotics should be avoided:

  • Aminoglycosides: unless no other medication can be used