How is acute pyelonephritis treated?

Acute pyelonephritis is a disease with a relatively high incidence in daily life. If it is not treated in time or incorrectly, it can easily cause more serious harm to human health. So how should acute pyelonephritis be treated? In fact, there are three treatment principles. The first treatment principle is to control infection.

1. Control infection and select appropriate antibiotics in time. Do not wait for urine culture results and drug sensitivity test reports to avoid delaying the disease. Antibiotics that are sensitive to Gram-negative bacilli are generally preferred because 80% of pyelonephritis is caused by such bacteria. Or use urine sediment smear and Gram stain to select antibiotics. It is better to choose antibiotics with a broader antibacterial spectrum. Moreover, the selected drugs have high concentrations in the blood and urine and have low nephrotoxicity. If the medication is ineffective after 72 hours (symptoms do not improve or urine test results show no improvement), other antibiotics should be changed. Frequent medication changes should not be made.

The full course of treatment is required, which is generally 10-14 days, or continued medication for 3-5 days after symptoms are relieved. The patient should be followed up and observed after discontinuation of the medication, and urine routine and urine bacterial culture should be checked once a week. The patient can be considered cured only if there is no pyuria or bacillus inuria after 6 weeks. If the course of treatment is short, the treatment is incomplete, or there is no follow-up after stopping the medication, the disease may relapse or become chronic, so it is very important to take a full course of medication and follow up.

2. Eliminate the predisposing factors. If the symptoms do not improve with regular antibiotic treatment, and pyuria or bacteriuria does not disappear, the factors that induce pyelonephritis - the predisposing factors - should be actively sought and treated. Such as solving urinary tract obstruction, treating chronic diseases, correcting metabolic disorders, etc.

3 Symptomatic treatment: Bed rest and a high-calorie, high-vitamin diet can help patients with acute pyelonephritis recover. It is important to give enough water to flush the urinary tract and encourage drinking plenty of water to maintain adequate urine volume. For those with obvious symptoms of urinary urgency, frequent urination, and painful urination, analgesics such as belladonna and atropine can be given, or acupuncture therapy (selecting acupoints such as Zusanli, Guanyuan, Zhongji or Sanyinjiao) can be used to relieve urinary pain and difficulty in urination. Taking sodium bicarbonate to alkalinize urine can also help relieve urinary tract discomfort such as painful urination.

Control infection: When patients develop infection, they should choose appropriate antibiotics in a timely manner and do not wait for the results of urine culture and medical sensitivity tests to avoid delaying the treatment. Antibiotics that are sensitive to Gram-negative bacilli are generally preferred because 80% of pyelonephritis is caused by such bacteria. Or use urine sediment smear and Gram stain to select antibiotics. Moreover, the selected drugs have high concentrations in the blood and urine and have low nephrotoxicity. If the treatment is ineffective after 72 hours (symptoms do not improve or urine test results do not improve), other antibiotics may be used, but frequent changes of antibiotics are not recommended.