6.3.3 Pyelonephritis

Intravenous antibiotic therapy with a broad-spectrum penicillin or cephalosporin is started immediately. In case of non-sensitive bacteria, a reserve antibiotic agent is chosen. In newborns, treatment should last for 14-21 days. The therapy is then continued orally for 7-14 days. In impaired renal function, the dosage is adjusted according to the serum creatinine level. Therapy can be stopped when urine culture is sterile and all signs of inflammation have disappeared. DMSA scintigraphy may be performed 3 months after the end of treatment. In obstructive pyelonephritis, urinary drainage should be considered as an emergency.