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Treatment of xanthogranulomatous pyelonephritis involves antibiotics as well as surgery. Removal of the kidney is the best surgical treatment in the overwhelming majority of cases, although polar resection (partial nephrectomy) has been effective for some people with localized disease.
For the treatment of simple cystitis in children, a five-day oral course of cephalexin is the preferred choice. As for children with suspected pyelonephritis, a ten-day treatment regimen is recommended. In such cases, a third-generation cephalosporin, such as cefdinir, is suggested as an appropriate option.
In the EU, cefepime/enmetazobactam is indicated for the treatment of complicated urinary tract infections, including pyelonephritis; [2] hospital-acquired pneumonia, including ventilator-associated pneumonia; [2] and the treatment of people with bacteremia that occurs in association with, or is suspected to be associated with, any of the ...
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. [87]
The stent is removed by cystoscopy, an outpatient procedure. Cystoscopy involves placement of a small flexible tube through the urethra (the hole where urine exits the body). The procedure, which usually takes only a few minutes and causes little discomfort, is performed in an outpatient clinic or ambulatory surgery centre.
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.
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