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Pyelonephritis affects about 1 to 2 per 1,000 women each year and just under 0.5 per 1,000 males. [5] [7] Young adult females are most often affected, followed by the very young and old. [2] With treatment, outcomes are generally good in young adults.
Fosfomycin can be used as an effective treatment for both UTIs and complicated UTIs including acute pyelonephritis. [87] The standard regimen for complicated UTIs is an oral 3g dose administered once every 48 or 72 hours for a total of 3 doses or a 6 grams every 8 hours for 7 days to 14 days when fosfomycin is given in IV form.
Urinary anti-infective agent, also known as urinary antiseptic, is medication that can eliminate microorganisms causing urinary tract infection (UTI). UTI can be categorized into two primary types: cystitis, which refers to lower urinary tract or bladder infection, and pyelonephritis, which indicates upper urinary tract or kidney infection. [1]
This is because unlike Gram-negative Enterobacteriaceae urinary tract infections, S. saprophyticus does not reduce nitrate and has a longer generation time, thus does not consume glucose as rapidly. Even when such an infection occurs above the neck of the bladder, low numbers of colony-forming units (less than 10 5 cfu/ml) are often present.
The treatment of choice is penicillin, and the duration of treatment is around 10 days. [23] Antibiotic therapy (using injected penicillin) has been shown to reduce the risk of acute rheumatic fever. [24] In individuals with a penicillin allergy, erythromycin, other macrolides, and cephalosporins have been shown to be effective treatments. [25]
In ascending infections, fecal bacteria colonize the urethra and spread up the urinary tract to the bladder as well as to the kidneys (causing pyelonephritis), [37] or the prostate in males. Because women have a shorter urethra than men, they are 14 times more likely to suffer from an ascending UTI. [11]
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Together with intravenous antibiotics, drainage [8] —either percutaneous or retrograde with a ureteral stent [9] —has become the cornerstone of treatment since the development of ultrasonography and computed tomography (CT) scanning. Drainage offers a great outcome with low rates of morbidity and mortality.