Chronic pyelonephritis how to treat it what medications. What pills can treat pyelonephritis

03.09.2020

Complete collection and description: what medications should you drink for kidney pyelonephritis? and other information for human treatment.

How to treat pyelonephritis is decided exclusively by the urologist, and the choice of medication depends on what bacteria provoked it. The fact is that pyelonephritis is quite diverse in its manifestations: there are both unilateral and bilateral, and purulent, and serous, obstructive and non-obstructive, and it proceeds in different ways: in an acute form, chronic, there is also chronic pyelonephritis with exacerbations, therefore, treatment must take into account all these factors.

It is difficult to compile a complete list of drugs, because almost every day new pills and drugs appear, but there are also familiar schemes by which you can effectively treat inflammatory processes in the kidneys. Treatment of acute pyelonephritis and exacerbation of chronic is carried out in the same way, and in the chronic form of the disease during remission, it is important to prevent exacerbations.

Antimicrobial drugs

In the treatment of kidney inflammation, antibiotic therapy is the main component, because the disease is caused by bacteria in the vast majority of cases. It is best to choose medicines after testing for antibiotic sensitivity, but during acute pyelonephritis, when there is no time to think, drugs of the broadest action are prescribed. If the tablets are not very effective, they are replaced by others. Preparations for pyelonephritis should perform their main function - to treat inflammation, that is, to counteract its pathogens, not to worsen the condition of the kidneys, acting on them toxicly, and also have the ability to have a good concentration of the active substance in the urine. Such drugs are collectively called uroseptics.

Also, antimicrobial drugs are prescribed if pyelonephritis is in remission - to prevent and prevent relapses. If there is a risk of an exacerbation, antibiotics and other medications may be prescribed.

All drugs that are used to treat pyelonephritis can be divided into several groups. They need to be considered in detail.

Fluoroquinolones

These drugs are known for their bactericidal effect and good pharmacinetics. They disrupt the DNA synthesis of microbial cells and kill gram-positive bacteria (for example, pneumococci), intracellular pathogens and anaerobes. The following tablets are usually prescribed for the treatment of kidneys:

norfloxacin;
pefloxacin;
lomefloxacin;
ciprofloxacin;
ofloxacin;
levofloxacin.

Sulfonamides

These drugs are given less frequently than antibiotics. Their bacteriostatic properties are needed to combat gram-positive and gram-negative cocci, chlamydia and gram-negative rods. However, they have no effect on anaerobes, which can cause pyelonephritis, as well as on enterococci and Pseudomonas aeruginosa.

For the treatment of pyelonephritis, the following are prescribed:

urosulfan;
biseptol (bactrim);
groseptol;
lidaprim.

In our time, they are not so popular, they were replaced by fluoroquinolones and other modern drugs, but sometimes the treatment of pyelonephritis with these drugs is quite justified. For example, to combat gram-negative bacteria, Trichomonas and lamblia. In the treatment of kidney and bladder, the most commonly prescribed are furadonin (nitrofurantoin) and the less toxic furazidine (furamag). They are usually treated for chronic pyelonephritis.

For severe kidney damage, nalixidic acid derivatives (eg, nevigramone) may be prescribed. As a preventive treatment, herbal antiseptics can be prescribed, for example, Kanefron N.

Other medicines

Treatment does not end with the fight against bacteria - it is equally important to relieve the symptoms of inflammation and intoxication, as well as improve blood circulation in the kidneys.

To remove toxins, intravenous drugs are used, for example, reosorbilact, as well as intestinal sorbents. It is equally important to suppress inflammation. With pyelonephritis, paracetamol and nimesulide are prescribed for these purposes.

Also, with this disease, drugs are needed to improve vascular tone (for example, troxevasin), and heparin to reduce blood clotting. Strong diuretics can also be useful, with the help of which the so-called renal gymnastics is performed.

Pyelonephritis treatment: what drugs

Treatment of inflammation of the calyx-pelvic system is possible only after the identification of pathogenetic, morphological, symptomatic links. You need to choose not only drugs, the quality of food, diet, and rest regime are important.

The need for hospitalization is determined by the patient's condition, the likelihood of complications, and the risk to a person's life. Bed rest for 7 days is rational for pain syndrome, severe fever.

Diet for pyelonephritis

The diet for inflammation of the calyx-pelvic system is aimed at reducing the renal load. Doctors prescribe a table number 5 according to Pevzner for pathology. It is prescribed for exacerbation of a chronic form or acute activity of the disease. The essence of diet therapy is salt restriction, and fluid intake decreases as kidney function decreases.

The optimal balance of nutritional ingredients, vitamins, trace elements is achieved by alternating protein and plant foods. Spicy, fatty, fried foods should be excluded; extractive and essential oils should be discarded.

The basis of drug treatment is antibiotics. What medicines to use is determined according to the following principles:

Bacterial culture of urine to determine antibiotic sensitivity;
Empiric treatment with fluoroquinolones for 2 weeks;
Assessment of bacteriuria throughout the course of medication;
The lack of effect of therapy is assessed as a failure in treatment;
Preservation of bacteriuria - low effectiveness of therapy;
Short courses of antibiotics are prescribed for primary urinary tract infection;
Long-term therapy is carried out with infection of the upper urinary tract;
In case of relapses, bacterial culture is required to determine flora and sensitivity.

The main stages of antibiotic therapy for pyelonephritis:

Suppression of the inflammatory process;
Pathogenetic therapy when the inflammatory process subsides;
Immunocorrection with antioxidant protection after 10 days of treatment with antibacterial agents;
Anti-relapse treatment of the chronic form.

Pyelonephritis is treated with antibacterial agents in 2 stages. The first one is to eliminate the pathogen. Consists of empiric therapy, targeted treatment after bacterial culture results, diuretic therapy. Infusion corrective treatments can help manage additional symptoms. Hemodynamic disorders require additional correction.

Acute pyelonephritis is treated with antibiotics successfully after culture results. The test allows you to assess the sensitivity of the combined flora. For a physician, the result of a bacteriological study is important to determine which antibiotics to treat the inflammatory process of the pelvis-pelvis system.

Essential antibiotics for treating kidney inflammation

The selection of an antibiotic is carried out according to the following criteria:

Activity against the main infectious agents;
Lack of nephrotoxicity;
High concentration in the lesion focus;
Bactericidal;
Activity in the pathological acid-base balance of the patient's urine;
Synergism with multiple drugs.

The duration of antibiotic therapy should not be less than 10 days. At this time, the formation of protective forms of bacteria is prevented. Inpatient treatment lasts at least 4 weeks. The drug should be changed approximately every week. To prevent repeated relapses of the disease, nephrologists recommend combining antibiotics with uroseptics. The drugs prevent recurrent exacerbations.

Empiric treatment of pyelonephritis: starting antibiotics

Starting antibacterial drugs for pyelonephritis:

The combination of beta-lactamase inhibitors with semi-synthetic penicillins (amoxicillin in combination with clavulanic acid) - augmentin in a daily dose of 25-50 mcg, amoxiclav - up to 49 mcg per kilogram of body weight per day;
2nd generation cephalosporins: cefamandol, 100 mcg per kilogram, cefuroxime;
3rd generation cephalosporins: ceftazidime 80-200 mg, cefoperazone, intravenous ceftriaxone 100 mg;
Aminoglycosides: gentamicin sulfate - 3-6 mg intravenously, amikacin - 30 mg intravenously.

Antibacterial drugs when the activity of the inflammatory process subsides:

2nd generation cephalosporins: vercef, ceclor, 30-40 mg;
Semi-synthetic penicillins in combination with beta-lactamases (augmentin);
3rd generation cephalosporins: cedex at 9 mg per kilogram;
Nitrofuran derivatives: furadonin 7 mg;
Quinolone derivatives: nalidixic acid (nevigramone), nitroxoline (5-nitrox), pipemidic acid (pimidel), 0.5 grams per day;
Trimethoprim, sulfamethoxazole - 5-6 mg per kilogram of body weight.

Severe septic form of pyelonephritis with the presence of multidrug resistance of the flora to antibacterial drugs requires a long search of drugs. Correct treatment also includes bactericidal and bacteriostatic drugs. Combined therapy is carried out for a month in acute and chronic forms of the disease.

Bactericidal drugs for inflammation of the renal calyx:

Polymyxins;
Aminoglycosides;
Cephalosporins;
Penicillins.

Bacteriostatic agents:

Lincomycin;
Chloramphenicol;
Tetracyclines;
Macrolides.

When choosing a tactic for treating a disease, the synergism of drugs must be taken into account. The most optimal combinations of antibiotics: aminoglycosides and cephalosporins, penicillins and cephalosporins, penicillins and aminoglycosides.

Antagonistic relationships were found between the following drugs: chloramphenicol and macrolides, tetracyclines and penicillins, chloramphenicol and penicillins.

The following drugs are considered to be low toxic and nephrotoxic: tetracycline, gentamicin, cephalosporins, penicillins, polymyxin, monomycin, kanamycin.

Aminoglycosides should not be used for more than 11 days. After this period, their toxicity increases significantly when the drug concentration in the blood reaches over 10 μg per milliliter. When drugs are combined with cephalosporins, a high creatinine content is achieved.

To reduce toxicity after a course of antibiotic therapy, it is advisable to carry out additional treatment with uroantiseptics. Nalidixic acid preparations (blacks) are prescribed to children over 2 years old. Medicines have a bactericidal and bacteriostatic effect on the effect on gram-negative flora. Do not use these antiseptics in conjunction with nitrofurans for more than 10 days.

Gramurin has a wide spectrum of antibacterial action. The oxolinic acid derivative is prescribed for 10 days.

Pimidel has a positive effect on most gram-negative bacteria. Suppresses the activity of staphylococci. Treatment with the drug is carried out in a short course lasting 7-10 days.

Nitrofurans and nitroxoline have a bactericidal effect. Medicines have a wide range of effects on bacteria.

Zanocin is a reserve agent. The wide spectrum of action of the drug on the intracellular flora allows the use of the drug with a low effect from other uroseptics. The impossibility of prescribing a drug as the main therapeutic agent is due to its high toxicity.

Biseptol is a good anti-relapse medicine for pyelonephritis. It is used for long-term inflammation of the calyx-pelvis system.

What diuretics are used to treat pyelonephritis

In addition to antibiotics, in the first days, pyelonephritis is treated with fast-acting diuretics. Veroshpiron, furosemide - drugs that increase the activity of renal blood flow. The mechanism is aimed at removing microorganisms and inflammatory products from the edematous tissue of the pelvis. The volume of infusion therapy depends on the severity of intoxication, diuresis indicators, and the patient's condition.

Pathogenetic treatment is prescribed for the microbial-inflammatory process against the background of antibiotic therapy. The duration of therapy is no more than 7 days. When combining treatment with anti-sclerotic, immunocorrective, antioxidant, anti-inflammatory therapy, one can count on the complete eradication of microorganisms.

Reception of Surgam, Voltaren, Ortofen is carried out for 14 days. Indomethacin is contraindicated in children. To prevent the negative effect of the anti-inflammatory drug indomethacin on the child's gastrointestinal tract, it is not recommended to use the drugs for more than 10 days. Drinking plenty of fluids is recommended to improve blood flow to the kidneys, increase filtration, and restore electrolyte and water balance.

Desensitizing drugs (claritin, suprastin, tavegil) are used for chronic or acute pyelonephritis. Relief of allergic reactions, prevention of sensitization is carried out with the help of tocopherol acetate, unitiol, beta-carotene, trental, cinnarizine, aminophylline.

Immunocorrective therapy is prescribed for the following indications:

Serious kidney damage (multiple organ failure, obstructive pyelonephritis, purulent inflammation, hydronephrosis, megaureter);
Breast age;
The duration of the inflammation is more than a month;
Intolerance to antibiotics;
Mixed microflora or mixed infection.

Immunocorrection is prescribed only after consultation with an immunologist.

Chronic pyelonephritis, what immunotropics to treat:

Lysozyme;
Myelopid;
Cycloferon;
Viferon;
Leukinferon;
Reaferon;
Imunofan;
Likopid;
Levamisole;
T-activin.

If a secondarily contracted kidney is detected in a patient, drugs with an anti-sclerotic effect lasting more than 6 weeks (delagil) should be used.

Against the background of remission, herbal teas are prescribed (chamomile, wild rose, yarrow, birch buds, bearberry, lovage, corn silk, nettles).

Antibiotics are prescribed at the stage of anti-relapse therapy, lasting about a year with periodic interruptions.

The diet is combined with all of the above stages. In the acute form, it is important to adhere to bed rest for a week.

Anti-relapse drugs are prescribed on an outpatient basis. Biseptol is prescribed at a dose of 2 mg per kilogram, sulfamethoxazole - once a day for 4 weeks. Furagin at the rate of 8 mg per kilogram of weight for a week. Treatment with pipemidic or nalidixic acid is carried out for 5-8 weeks. The overlapping scheme involves the use of biseptol or nitroxoline at a dosage of two to 10 mg. For the treatment of recurrent forms, nitroxoline can be used in the morning and in the evening at a similar dose.

When assessing which antibiotics to treat pyelonephritis, many factors should be taken into account that arise during inflammation of the renal calyx-pelvis system.

Pyelonephritis is one of the most common nephrological diseases. This ailment affects the renal pelvis and the parenchyma of the kidney, causes impaired urination, pain in the lumbar region, and may even end in an abscess. Not the most pleasant consequence of the acute form is its transition to the chronic form, which is much more difficult to treat. That is why it is important to diagnose the disease on time and start taking the necessary pills from pyelonephritis to serious complications.

Treatment methods

In the acute course of the disease, its main symptoms are fever, weakness, muscle pain - all those signs that accompany almost any infectious process in the body. Later, pain in the lumbar region is added to these symptoms, usually on one side. Therefore, pyelonephritis tablets are prescribed in order to solve two main problems:

relieve symptoms to relieve the patient's condition,
eliminate the infection.

Another question is the cause of the disease, it is important to find out the nature of the occurrence in order to prevent relapses.

Treatment of pyelonephritis with tablets, as noted above, has two directions... To eliminate symptoms, apply:

analgesics, most often these are combined drugs, including an analgesic and antispasmodic component. It is not recommended to take non-steroidal anti-inflammatory drugs due to their nephrotoxicity.
antipyretics - paracetamol is usually used. By the way, in a sufficiently high dose (up to 1000 mg), it may well relieve pain.

Antibiotics

To eliminate the infectious agent, antibiotics and antimicrobial agents of various groups are used. Antibiotics for pyelonephritis should be selected on the basis of urine test data, which will show not only the causative agent of the disease, but can also help establish its sensitivity to a particular antibiotic in a given patient. Unfortunately, in our country, the method of selecting antibiotics based on the effectiveness or ineffectiveness of treatment has taken root more, although the initially correctly selected drug can significantly accelerate the treatment of pyelonephritis. The antibiotics most commonly used for this disease belong to the following groups:

Penicillin antibiotics (amoxicillin, ampicillin, etc.), this also includes combinations of penicillins with clavulonic acid, for example Amoxiclav. With pyelonephritis, this group of drugs has been used for a long time and quite successfully.
Injectable cephalosporin antibiotics of II and III generations (cefatoxime, cefazolin).

It is important that antibiotics for pyelonephritis and cystitis, as well as for other infectious diseases, are taken with a mandatory minimum course of 7 days, and if necessary, the duration of antibiotic therapy can be increased to two weeks.

Another group of drugs that fight infection in diseases of the urinary system are antimicrobial drugs. These are synthetic compounds of the following chemical classes:

Fluoroquinolones (ciprofloxacin, norfloxacin, ofloxacin, etc.). It should be noted that in the treatment of urological diseases, the drug of choice is norfloxacin.
Nitrofurans (furadonin, furamag, etc.). These are quite old, but quite effective drugs.
Oxyquinolines (nitroxoline). It is also a long-known group of drugs, but due to its active use in the treatment of diseases of the urinary system, the sensitivity of many microorganisms to them has significantly decreased in recent years.
Sudphanilamides. This is the well-known Biseptol, which currently does not have sufficient effectiveness in the fight against infections.
Phosphonic acid derivatives. Today this is the only drug - fosfomycin. In pharmacies, it is dispensed under the original trade name Monural and for pyelonephritis this drug is not used so often and, as a rule, is prescribed for the treatment of cystitis. But it is worth noting its powerful and fast antimicrobial action throughout the urinary system. Monural is a fairly effective medicine for pyelonephritis, which can be prescribed in the complex treatment of the disease.

Uroseptics for pyelonephritis are one of the main groups of drugs, along with antibiotics, they affect the urinary tract. Almost all antibiotics can be attributed to this group, since they pass through the kidneys and are excreted in the urine, but the best uroseptic will be the one that retains antibacterial activity as much as possible when excreted through the urinary tract.

Herbal preparations

Herbal medicines are also used in the complex treatment of kidney inflammation.... These can be independent medicinal herbs (bearberry, lingonberry, birch buds, etc.), multicomponent collections (urological collection), or medicinal preparations based on various herbs. Fitolysin works quite effectively for pyelonephritis, the drug is a plant-based paste, which is diluted with water and taken orally. Phytolysin contains extracts of birch leaf, horsetail herb, parsley root, knotweed herb, etc. The drug has anti-inflammatory, antimicrobial, diuretic and antispasmodic effects.

To date, there are many different drug treatments for pyelonephritis. But only a doctor can choose them correctly, so if signs of an inflammatory process in the kidneys or back pain appear, consult a specialist.

Pyelonephritis is a non-specific infectious and inflammatory kidney disease with damage mainly to the parenchyma, pelvis and calyx and the further development of secondary nephrosclerosis. It is the most common kidney disease among all age groups. Young and middle-aged men get sick 6 times less often than women. With timely treatment started, you can achieve a stable remission of the disease.

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Basic concepts

Pyelonephritis is a nonspecific inflammatory process of bacterial etiology with damage to the tubular system of the kidneys, damage to the renal parenchyma (mainly its interstitial tissue), calyces and renal pelvis (pyelitis).

The main causative agents of the disease include gram-negative bacteria of the intestinal group, enterococci, staphylococci, streptococci, Pseudomonas aeruginosa, viruses, proteas, mycoplasmas, candida and many others.

Infection occurs in three ways:

lymphogenous;
urogenic (through the urethra, bladder and ureters);
hematogenous.

In men, the last route of infection due to bacteremia prevails (in the presence of a chronic or acute infection in the body - osteomyelitis, appendicitis, etc.).

The contributing factors are:

abnormalities in the development of the kidneys;
concomitant chronic diseases;
metabolic disorders (diabetes mellitus, gout);
unprotected sex;
obstruction of the urinary tract;
vesicoureteral reflux.

Consequences of vesicoureteral reflux

The main reasons for the development of pyelonephritis:

metabolic toxins (hypercalcemia, gout, oxalaturia, etc.);
exogenous toxins (heavy metals, analgesics, antibacterial agents);
vascular disorders (nephrosclerosis, acute tubular necrosis);
neoplasms (lymphoma, myeloma, leukemia);
immune disorders (amyloidosis, glomerulosclerosis, Sjogren's disease);
hereditary kidney disease (polycystic);
mixed pathologies (vesicoureteral reflux, urinary tract obstruction, radiation nephritis).

Classification

On the basis of excisional and puncture biopsy of kidney tissues, 3 main variants of the course of the disease are determined:

spicy;
chronic;
chronic with rare and frequent exacerbations.

Depending on the etiology, the primary and secondary forms are considered. According to localization, single and bilateral pyelonephritis are distinguished. In form - obstructive and non-obstructive. The causes of obstructive pyelonephritis are always urodynamic disorders (vesicoureteral reflux) and mechanical factors of occlusion of the upper urinary tract (inflammatory detritus, calculi, strictures of the ureter, compression from the outside, blood clots, etc.), as a result of which there are violations of urine excretion from the kidneys into the urinary tract. A non-obstructive type of ailment develops in the absence of structural and functional damage in the kidneys and urinary tract.

Both primary and secondary acute pyelonephritis initially usually proceed in the form of a serous process, and then turn into a form of purulent interstitial inflammation. As a rule, serous pyelonephritis, in the absence of timely and adequate treatment, turns into purulent. In this regard, it is customary to be guided by the terms "acute serous pyelonephritis" and "acute purulent pyelonephritis". The latter is presented in the form of an abscess, apostematous nephritis and a kidney carbuncle.

can occur as a result of an acute process or develop as primary chronic.

With the progression of a chronic ailment, sclerosis of arterioles and further atrophy of the renal parenchyma develop, which ultimately ends with pyelonephritic wrinkling and renal failure.

Clinical manifestations

The symptoms of the disease are quite diverse. The disease is characterized by several clinical and laboratory syndromes:

Syndromes	Manifestations
Painful	Pain in the lumbar region on the side of the lesion is characteristic: in obstructive forms, they are usually acute, prolonged, paroxysmal (for example, with obstruction of the ureter with a stone with the development of calculous pyelonephritis); with non-obstructive pyelonephritis, painful sensations of a dull nature, unstable, aching, low intensity or reaching high severity, sometimes take on a paroxysmal character. When tapping in the lumbar region (), there is discomfort from the affected kidney
Inflammatory	Characterized by headache, increased fatigue, lethargy, decreased performance, increased body temperature up to febrile numbers (more often in the evening), chills, decreased appetite, aching lower back pain
Uric	Severe bacteriuria and leukocyturia, pollakiuria (frequent urination), polyuria, nocturia (predominance over daytime), microhematuria, slight proteinuria, isostenuria
Chronic renal failure syndrome	Dry skin, pallor, nausea and vomiting, anorexia, nosebleeds, renal osteodystrophy, acidosis, a specific smell of ammonia from the mouth (sweetish), uremia
Changes in blood	Anemia, left-shift leukocytosis, urea and residual nitrogen

On examination, puffiness of the face, pallor of the skin with a yellowish tinge, puffiness or pastiness of the eyelids (especially after a night's sleep) are determined. Also, pyelonephritis is characterized by an increase in blood pressure unexplained by other reasons (more than diastolic, or "renal").

Unlike adults, children are characterized by a more pronounced manifestation of intoxication disorders, as well as the development of abdominal syndrome (intense pain in the abdomen against the background of absence or mild pain in the lumbar region). ). Elderly and senile people are characterized by the erased clinic of pyelonephritis, the development of atypical clinical symptoms or the course of the disease with pronounced general manifestations against the background of the absence of local symptoms.

Diagnostics

There are many different research methods. These include:

general and biochemical blood and urine tests;
urine analysis according to Zimnitsky and Nechiporenko;
urological examination (examination of the prostate gland, cystoscopy);
Ultrasound of the kidneys (increase in size, restriction of mobility during breathing, determination of echogenicity of the parenchyma, detection of calculi);
abdominal x-ray;
overview and excretory urography (increase in size, indistinctness of the contours of the kidneys, deformities, shadows of calculi);
cystography (registers vesicular urethral reflux);
CT, MRI of the kidneys.

The most reliable and common analysis is the study of urine sediment with the establishment of bacteriuria (more than 100,000 in 1 ml) and with the determination of antibiotic sensitivity.

Typical indicators for detecting bacteriuria

Treatment

In the treatment of pyelonephritis in men, conservative and surgical methods are considered. Among the conservative methods, drug therapy is also distinguished to improve the outflow of urine.

The main medical methods of treatment are antiseptic and antibacterial agents (selected taking into account the sensitivity of microflora), infusion-detoxification, anti-inflammatory, physiotherapy. It is also advisable to prescribe anticoagulants and antiplatelet agents.

Necessary measures before starting treatment:

establishing the type of pathogen, its sensitivity to antibacterial drugs;
determination of the degree of activity of the infectious and inflammatory process;
exclusion of factors that aggravate the course of pyelonephritis (diabetes mellitus, obstruction of the urinary tract, developmental anomalies, etc.);
clarification of the state of urodynamics (presence or absence of violations of urine release);
assessment of the functional state of the kidneys.

Therapy for chronic pyelonephritis is divided into two stages:

exacerbation treatment;
anti-relapse therapy.

All medicines are selected by the doctor depending on the individual indications and the patient's condition.

Drug therapy

Antibacterial drugs used for the treatment of pyelonephritis should be characterized by minimal nephrotoxicity, have a broad spectrum of action, pronounced bactericidal properties and be excreted in the urine in high concentrations.

Types of antibacterial agents:

antibiotics (fluoroquinolones, cephalosporins, protected aminoglycosides);
derivatives of 8-hydroxyquinoline;
nitrofurans;
sulfonamides;
quinolones (derivatives of pipemidic and nalidixic acid);
uroantiseptics of plant origin.

Protected penicillins (sulbactam + ampicillin, clavulanate + amoxicillin) are considered the drugs of choice as drugs for empiric therapy. If Pseudomonas aeruginosa is detected, as well as in complicated forms of pyelonephritis, ureidopenicillins (azlocillin, piperacillin) or carboxypenicillins (ticarcillin, carbenicillin) may be prescribed.

In addition to drugs of the penicillin series, cephalosporins are widespread, which have moderate nephrotoxicity and are capable of accumulating in the renal parenchyma and urine in high doses.

2nd generation cephalosporins (Cefuroxime and others) are preferred as therapy for uncomplicated forms of pyelonephritis in outpatient practice. For complicated forms of the disease, 3rd generation cephalosporins are recommended for enteral (ceftibuten, cefixime, etc.) and parenteral administration (ceftriaxone, cefotaxime, etc.). In relation to gram-positive cocci, 4th generation cephalosporins (cefepime) are more effective.

The drugs of choice for both outpatient and inpatient treatment of pyelonephritis should include 1st generation fluoroquinolones (ciprofloxacin, ofloxacin, pefloxacin), which have low toxicity, are active against a large number of microbial agents of genitourinary infections and are well tolerated by patients.

The names of the 2nd generation fluoroquinolones drugs are: Moxifloxacin, Levofloxacin, Sparfloxacin, Lomefloxacin. Complicated and especially severe forms of pyelonephritis are recommended to be treated with reserve medications - carbapenems (Meropenem, Imipenem).

In addition to antibiotics, they also use other antimicrobial drugs, which are sometimes prescribed in combination with them, are used as long-term therapy for the purpose of prophylaxis after antibiotic withdrawal. These include:

combined antimicrobial agents (Co-Trimoxazole);
8-hydroxyquinolines (Nitroxoline);
nitrofurans (Furazidin, Nitrofurantoin);
nalidixic and pipemidic acid.

Principles of therapy

After correcting all possible causes of impaired urinary excretion, treatment of pyelonephritis is started.

Initially, therapy is carried out until the results of a bacteriological study of the culture are obtained and is represented by antimicrobial agents of a wide spectrum of action. Then, after urine culture and antibiotic sensitivity, it takes on an empirical form and is corrected with narrow-acting antimicrobial drugs. During treatment, you must drink at least 1.5 liters of water per day.

The drugs of the first rank, or drugs of choice, which are determined as optimal, and second-line drugs, or alternative drugs, are allocated.

Empiric antibiotic therapy for outpatient treatment of patients with mild to moderate exacerbation of chronic pyelonephritis:

In severe and complicated forms of pyelonephritis, immediate hospitalization is recommended. Inpatient treatment of such patients is described in the table:

Basic drugs

Reserve drugs

Amoxicillin / clavulanate - first intravenous injections 1.0 g / 0.2 g 3 r. / Day. - 5 days, then in tablets of 500 mg / 125 mg 3 r. / Day. lasting 9 days.
Ciprofloxacin IV 200 mg 2 times / day, then inside 250 mg 2 times / day.
Ofloxacin i.v. 200 mg 2 r. / Day, then 200 mg orally 2 r. / day
Levofloxacin intravenously 500 mg 1 r. / Day, then inside 500 mg 1 r. / Day.
Pefloxacin IV 400 mg 2 times / day, inside 400 mg 2 times / day lasting 9 days.
Cefotaxime IV or IM 1-2 g 2-3 r. / Day.
Ceftriaxone IV or IM 1–2 g 1 r. / Day.
Ceftazidime i / v or i / m 1–2 g 2–3 r. / day lasting 14 days

Imipenem / cilastatin i.m. 500 mg 2 r. / day lasting 14 days.
Ticarcillin / clavulanate IV 3.0 g / 0.2 g 3-4 r. / day
Gentamicin IV or IM 80 mg 3 r. / Day for 14 days

The duration of therapy with antibacterial agents in the period is equal to 10-21 days. 30 days after the end of treatment, a control examination of urine is performed. If the pathogen is preserved, it is recommended to conduct a second course, taking into account antibacterial sensitivity.

With pyelonephritis of a single kidney, therapy is performed according to the generally accepted method, but there is a need to control the nephrotoxicity of drugs (the use of carbapenems, aminoglycosides and first generation cephalosporins should be excluded).

Performance criteria

There are 3 main groups of indicators of the effectiveness of antibiotic therapy:

Name	Description
Early (after 48-72 hours)	Clinical symptoms of positive dynamics: decrease in the severity of intoxication; decrease in body temperature; improving general well-being; sterility of urine on the 2nd - 3rd day of the treatment; normalization of kidney function
Late (after 14-30 days)	Clinic of persistent positive dynamics: the absence within 2 weeks after the end of antibiotic therapy of chills; obtaining negative results of bacteriological examination of urine on the 3rd - 7th day after the end of antibiotic therapy; no recurrence of body temperature rise
Final (after 1-3 months)	Absence during the first 12 weeks after therapy with antibacterial drugs of repeated exacerbations of pyelonephritis

Blood pressure control

Difficulties in lowering blood pressure to target values \u200b\u200bis a characteristic feature of arterial hypertension in chronic pyelonephritis. When choosing antihypertensive therapy, preference should be given to drugs with maximum nephroprotective activity.

The first in the list of such drugs are ACE inhibitors, the nephroprotective effect of which has a certain dose dependence: is the prevention of irreversible renal dysfunction and a decrease in the incidence of complications, especially cardiovascular complications.

With a decrease in renal function, homeostasis disorders are considered in the form of electrolyte balance disorders, acid-base state, water-salt metabolism, endocrine and immune functions, delay of nitrogenous toxins, hemorrhagic complications. Ultimately, this can lead to the development of end-stage renal failure (RN), which is fraught with dire consequences and requires the immediate transfer of the patient to hemodialysis or organ transplantation.

Prevention of the progression of PN is aimed at correcting risk factors, treating the underlying disease and developing complications (arterial hypertension, metabolic processes, hemorrhagic disorders, etc.). Nephroprotective treatment is important.

With complications of CRF pyelonephritis, there are contraindications, therefore, the approach to drug therapy should be carried out with great caution.

Treatment of the disease against the background of chronic renal failure is described in the table:

Preventive actions

After relief of the symptoms of exacerbation of chronic pyelonephritis, long-term preventive measures are taken. Recommended long-term, lasting at least six months, the use of low doses of ciprofloxacin, ofloxacin or nitrofurantoin, especially for patients prone to frequent recurrence of the disease.

In between courses of antibiotics, the appointment is shown:

decoctions of herbs (leaves of lingonberry, wild strawberry, bearberry, birch; berries of cranberries, lingonberries, etc.);
combined herbal medicines (Kanefron, etc.).

The phytopreparation Urolesan is highly effective, possessing anti-inflammatory, antiseptic, diuretic, antispasmodic and choleretic effects.

Nutrition for chronic pyelonephritis does not differ from the usual diet, restriction of fluid and salt is necessary only in case of complications such as edema, arterial hypertension, renal failure, etc. A sufficient drinking regime is recommended - daily 1.5–2 liters. Patients with chronic pyelonephritis without exacerbation, without a pronounced increase in blood pressure (up to 179/109 mm Hg) and with adequate kidney function can be prescribed spa treatment in the cities of Mineralnye Vody, Zheleznovodsk, Truskavets, Karlovy Vary, Kislovodsk.

Tablets for pyelonephritis, which are prescribed for inflammation of the pelvis and interstitial tissue of the kidneys, are aimed at eliminating infection, relieving the inflammatory process and normalizing the outflow of urine. Also, drugs are able to act directly on the cause of the pathology. Today it exists. Only a doctor can prescribe certain medications for effective treatment, depending on the type of pathogen and the course of the disease.

Drug therapy for pyelonephritis consists in taking the following drugs:

antibiotics;
drugs to improve renal circulation;
anti-inflammatory and antispasmodic drugs;
immunostimulants and vitamin complexes.

Antibacterial drugs

With renal inflammation, antibiotic therapy is the main component, because most often pathology is provoked by pathogens. Antibacterial agents in the form of tablets are presented in several groups - depending on the therapeutic effect on a particular pathogen. The appointment can only be made by a doctor after laboratory tests based on the nature of the course of the disease and the type of bacteria provocateurs.

Antibacterial drugs are divided into the following subgroups:

Third generation cephalosporins. The tablets are of low toxicity. It is prescribed to prevent the development of a purulent form of pyelonephritis. The active components of the drug can block the action of many forms of microorganisms. Most often used:

Cephalexin - well tolerated, has a minimum number of side effects. Sensitivity to tablets of streptococci, staphylococci, salmonella, E. coli is very high. The drug is not approved for use by children under three years old, pregnant, lactating women.

Zinnat - active ingredients allow pregnant women to use the drug during lactation.

Penicillins - Most often prescribed during pregnancy. In the usual state, they are rarely used as a leading agent, since they are sensitive to enzymes that some bacteria produce. Today, there are preparations containing clavulanic acid, which protects penicillin from destruction. The most common pills are:

Amoxiclav - due to the presence of amoxicillin and clavulanic acid, this water-soluble drug is very effective and easily tolerated.

Flemoklav Solutab is a broadly targeted antibiotic. It is active in the presence of gram-positive and gram-negative bacteria, inhibits the synthesis of their cells. Its reception is prohibited for children under 12 years of age and weighing less than 40 kg.

Fluoroquinolones - known for their bactericidal effect, disrupt the DNA synthesis of pathogens and have a detrimental effect on gram-positive bacteria. They are used in the treatment of chronic (Moxifloxacin, Levofloxacin) and acute (Ciprofloxacin, Norfloxacin) forms of pyelonephritis.
Carbapenems are broad-spectrum antibiotics used for severe forms of bacteremia complicated by sepsis. Tablets are used as a last resort when treatment with other drugs has not brought a positive effect. The famous representative is Imipenem.
Quinoline Compounds - The most common tablet formulation is Nitroxoline. It is highly effective, low cost and minimal side effects.

Anti-inflammatory and antispasmodic drugs

In complex drugs, in addition to antibacterial agents, anti-inflammatory therapy is used. In order to reduce the strength of inflammation and as an anti-febrile drug, they resort to the use of non-steroidal anti-inflammatory drugs. Their mechanism of action is to block the production of serotonin and prostaglandin, which provoke inflammation. They are prescribed during an exacerbation of the disease and are taken for no more than 3 days. Among the tablets that can reduce the pathological process in the kidneys, the most popular are Diclofenac, Movalis, Ibuprofen, Paracetamol (mainly indicated for children).

A side effect of using anti-inflammatory drugs is their effect on the gut.

Among the tablets with such an effect, Curantil should be noted. It helps to activate blood flow in the kidney tissues, reduces the constricting ability of platelets. Contraindicated in chronic renal failure and low blood pressure.

Another effective drug is Trental. It enriches the cells of the renal tissues with oxygen and promotes greater resistance of red blood cells, which carry oxygen to all systems.

Heparin is also often prescribed: it helps to reduce the rate of adhesion of platelets, improve blood microcirculation. Venoruton prevents capillary permeability and relieves swelling, increases blood flow in capillaries and outflow of venous blood from the kidneys.

Diuretics

With pyelonephritis, it is important to prevent intoxication of the body due to urinary retention. In this case, diuretics are prescribed, which can help to quickly remove stagnant urine.

Also, the appointment of diuretics is carried out for the purpose of training the kidney. To do this, alternate the load of the kidneys with taking pills that cause polyuria and a state of rest.

This mobilizes the reserve capacity of the organ. Only a doctor can prescribe the necessary drug based on the course of the disease, concomitant pathologies and the degree of kidney damage.

The most famous diuretics are:

Renephrin - tablets of plant origin, diuretic, antispasmodic, anti-inflammatory action;
Urokran is a natural complex diuretic;
Kanephron is a complex herbal remedy with a diuretic, anti-inflammatory and antimicrobial effect, which enhances antibacterial therapy;
Furosemide - diuretic tablets, a distinctive feature of which is that they must be taken 2-3 hours before daytime or nighttime sleep;
Urolesan is a herbal antispasmodic.

Most diuretic drugs are made from natural plants that have diuretic properties.

One of the reasons for the development of pathology is a decrease in immunity, therefore, in order to increase the body's defenses with pyelonephritis, Methyluracil or Pentoxil is prescribed. It is also necessary to receive ready-made multivitamin complexes (vitamins of groups A, C, E). With an exacerbation of chronic processes, they are prescribed in high doses.

All drugs that are used to treat pyelonephritis can be divided into several groups. They need to be considered in detail.

Fluoroquinolones

norfloxacin;
pefloxacin;
lomefloxacin;
ciprofloxacin;
ofloxacin;
levofloxacin.

Sulfonamides

For the treatment of pyelonephritis, the following are prescribed:

urosulfan;
biseptol (bactrim);
groseptol;
lidaprim.

For severe kidney damage, nalixidic acid derivatives (eg, nevigramone) may be prescribed. As a preventive treatment, herbal antiseptics can be prescribed, for example, Kanefron N.

Other medicines

Treatment does not end with the fight against bacteria - it is equally important to relieve the symptoms of inflammation and intoxication, as well as improve blood circulation in the kidneys.

Treatment methods

relieve symptoms to relieve the patient's condition,
eliminate the infection.

Another question is the cause of the disease, it is important to find out the nature of the occurrence in order to prevent relapses.

Treatment of pyelonephritis with tablets, as noted above, has two directions... To eliminate symptoms, apply:

analgesics, most often these are combined drugs, including an analgesic and antispasmodic component. It is not recommended to take non-steroidal anti-inflammatory drugs due to their nephrotoxicity.
antipyretics - paracetamol is usually used. By the way, in a sufficiently high dose (up to 1000 mg), it may well relieve pain.

Antibiotics

Penicillin antibiotics (amoxicillin, ampicillin, etc.), this also includes combinations of penicillins with clavulonic acid, for example Amoxiclav. With pyelonephritis, this group of drugs has been used for a long time and quite successfully.
Injectable cephalosporin antibiotics of II and III generations (cefatoxime, cefazolin).

Another group of drugs that fight infection in diseases of the urinary system are antimicrobial drugs. These are synthetic compounds of the following chemical classes:

Fluoroquinolones (ciprofloxacin, norfloxacin, ofloxacin, etc.). It should be noted that in the treatment of urological diseases, the drug of choice is norfloxacin.
Nitrofurans (furadonin, furamag, etc.). These are quite old, but quite effective drugs.
Oxyquinolines (nitroxoline). It is also a long-known group of drugs, but due to its active use in the treatment of diseases of the urinary system, the sensitivity of many microorganisms to them has significantly decreased in recent years.
Sudphanilamides. This is the well-known Biseptol, which currently does not have sufficient effectiveness in the fight against infections.
Phosphonic acid derivatives. Today this is the only drug - fosfomycin. In pharmacies, it is dispensed under the original trade name Monural and for pyelonephritis this drug is not used so often and, as a rule, is prescribed for the treatment of cystitis. But it is worth noting its powerful and fast antimicrobial action throughout the urinary system. Monural is a fairly effective medicine for pyelonephritis, which can be prescribed in the complex treatment of the disease.

Herbal preparations

Why are antibiotics effective in fighting pyelonephritis?

Antibiotics are drugs (natural or semi-synthetic) that can blunt or interfere with the growth or death of certain microorganisms. With pyelonephritis, antibiotics are most often prescribed in tablets. Moreover, the main requirements for antibacterial drugs in the treatment of pyelonephritis should be the presence of:

their high concentration in urine,
they should not have a toxic effect on the patient's kidneys.

What antibiotic is best for pyelonephritis? To answer this question, you need to conduct a survey in which

identify the causative agent of pyelonephritis,
determine the condition and function of the kidneys,
determine the state of urine outflow.

With the onset and development of pyelonephritis, the main role is assigned to bacteria (microorganisms) affecting mainly the tissues of the kidney, its pelvis and calyx, therefore, in the first rows, in the complex treatment of the disease, it is worth using by patients

antibiotics (Ampicillin, Amoxicillin, Cefaclor, Gentamicin).
sulfonamides (Co-Trimoxazole, Urosulfan, Etazole, Sulfadimezin).

Although they are prescribed for milder forms of the disease, sulfonamides are rarely used at present.

It is prescribed if there is a good outflow of urine, and there is no renal failure.

In the absence of one of the two conditions, the use of drugs is not used.

nitrofurans (Furadonin, Furagin, Furazolin)

Antibacterial drugs with a wide spectrum of action, and their concentration, in the patient's urine, is observed (the basis for clinical trials of drugs) within 10-15 hours.

industrial nalidixic acid (Negro, Nalidix).

Well tolerated by the body, but have little effect.

For the treatment of renal diseases, our readers have successfully used galina Savina's method.

Benefits of antibiotics over herbal remedies and other medications

treatment with phytopreparations and the achievement of the result occurs for a long period of time (during which pains and spasms are tormented). The course of antibiotics, as a rule, does not exceed a week and gives a quick effect.
excessive use of herbal remedies can cause a diuretic effect, the consequence of which is the "movement" of stones (the result of the secondary form of pyelonephritis).
the action of antibiotics is directed at the very focus of the disease and does not affect other areas (elimination of bacteria, normalization of body temperature, elimination of sediment in urine).

In the initial stages and as a preventive measure, some doctors advise

treatment of pyelonephritis with folk remedies

Which is absolutely safe for the body.

Pyelonephritis can occur not only in adults, but also in children. Read about the symptoms of kidney inflammation in a child

in our article

Antibacterial agents for the treatment of pyelonephritis

When mild forms of pyelonephritis treatment is carried out with drugs:

Urosulfan,
Etazol,
Sulfadimezin

They stop the growth of bacterial cells, are well absorbed from the stomach, and are not deposited in the urinary tract.

If there is no improvement within 2-3 days from the beginning of taking the drugs listed above, experts recommend adding the following antibiotics (taking into account the microbial infection). These include:

Penicillin

Erythromycin

Breastfeeding women are not prescribed, it is possible to influence the baby through breast milk. Application by children is possible.

Oleandomycin

It is an obsolete tool. In modern medicine, it is practically not used and is replaced by newer drugs.

Levomycetin

Contraindicated in pregnancy. It is prescribed for children from 3 years old.

Colimycin
Mitzerin.

When purulent forms of pyelonephritis prescribing drugs intravenously (antibiotics)

For the prevention of diseases and treatment of the kidneys and urinary system, our readers advise

Father George monastery tea

It consists of 16 of the most useful medicinal herbs, which are extremely effective in cleansing the kidneys, in the treatment of renal diseases, diseases of the urinary tract, as well as in cleansing the body as a whole.

The opinion of doctors ... "

Gentamicin
Sizomycin.

All drugs are aimed at blocking the development and suppression of microorganisms that affect the development of pyelonephritis.

The most commonly used in practice are:

Aminopenicilins (Amoxicillin, Ampicillin). Block the development of enterococci, Escherichia coli. Are prescribed for pregnant women in the treatment of inflammatory kidney processes.
Flemoklav Solutab (polysynthetic antibiotic). The difference and usefulness of this drug, from others, is in prescribing it to children from 3 months and pregnant women (most drugs are contraindicated).
Cephalosporin antibiotics (semi-synthetic and natural preparation). It is prescribed when there is a predisposition to the transition of pyelonephritis from an acute form to a purulent one. In most patients, there is an improvement in their condition on the 2nd day of taking the drug. This type includes:

Cephalexin
Cephalothin
Zinnat
Claforan
Tamycin.

Aminoglycosides (Gentamicin, Amikacin, Tobramycin). Appointed when severe pyelonephritis... They are nephrotoxic and may affect hearing impairment. Not assigned to people of the older age category and reapplying them allowed after one year from the beginning of the first application.
Fluoroquinolones. These include:

Ofloxacin
Ciprofloxacin.

They have a wide spectrum of action and are well tolerated by patients. Possess minimal toxic effectm per organism. Treatment with these antibiotics is prescribed for chronic pyelonephritis... Not prescribed for pregnant women.

Thus, for the treatment of pyelonephritis, today, there is a huge number of different drugs intended for both initial and subsequent forms of the disease.

The expediency and rationality of use depends on the complex treatment that a specialist will select.

The appointment of certain antibiotics depends on the microbe, which was the causative agent of the disease, and the characteristics of the age, the state of the patient's body.

It should be borne in mind that the selection of the dose depends on the individual characteristics of the patient (kidney anatomy, urine composition).

At the same time, of course, it is much easier to fight the disease in the early stages. That is why you should not start a painful condition and self-medicate. At the first symptoms of the disease, consult a doctor immediately.

Before trying to treat pyelonephritis, and especially at home, you should understand well which form of this disease worries us. Pyelonephritis is an inflammatory kidney disease in which the pelvis, calyx and even the outer tissue of the kidneys are affected.

The disease is of two types - as an acute inflammatory-infectious disease, which, with insufficient treatment, can turn into a chronic stage. And the second form is sluggish, with exacerbations, chronic pyelonephritis. In its chronic form, the disease can cause some complications such as high blood pressure and chronic renal failure.

Renal failure

Pyelonephritis can develop as a separate disease, and may be a consequence of other pathologies of the genitourinary system, such as urolithiasis, renal failure, diseases of the genital organs. For this reason, it is not recommended to treat the disease at home, but only under the supervision of a specialist. How is renal pyelonephritis treated?

Diagnostics

Diagnosis of the chronic form of the disease can proceed without noticeable symptoms for many years and be detected by chance, when a patient applies for other ailments. Or, there may be general ailments characteristic of numerous diseases: high fever, fatigue, lethargy, headaches, profuse sweating, alternating with chills.

This greatly complicates the diagnosis of the disease and leads to the fact that the disease will be detected too late and much more effort and time will be required for treatment. When diagnosing the disease, it is taken into account that in most cases, women suffer from pyelonephritis, which is associated with anatomical and physiological differences in the genitourinary system of men and women.

Signs of illness

Acute cases of renal pyelonephritis are much easier to diagnose and treat due to the more pronounced symptoms. It should also be borne in mind that inflammatory and infectious kidney disease can be a consequence of other diseases of the genitourinary system and, accordingly, the symptoms of the diseases that caused pyelonephritis will be added to the symptoms.

Symptoms of acute kidney pyelonephritis include:

The main, most significant symptom of inflammatory and infectious kidney disease will always be a change in the composition of urine, which, even without laboratory analysis, will be noticeable: it can be a general darkening and clouding of urine, a cloudy sediment and even blood in the urine. If the disease that caused the inflammation is kidney stone disease, then the urine will contain sand, fatty spots are possible. If the kidneys get infected, the urine will have a very unpleasant putrid odor.
Along with a change in the composition of urine, there will almost always be changes in the very process of urination. As a rule, the number of urges to urinate significantly increases (more than 10 times a day is already a deviation from the norm), while it happens that the volume of urine excretion will be completely insignificant. In many cases of inflammatory pyelonephritis, when urinating, the patient will feel an unpleasant burning sensation and stinging.
Lack of appetite, sometimes associated with nausea and vomiting, is not a specific symptom of this disease, but is present in the general clinical picture quite often.
Another mild symptom is high blood pressure, which, without laboratory analysis of urine, can also be considered symptoms of other diseases, hypertension, for example.
The presence of a high temperature, chills, profuse sweating in a patient is usually mistakenly referred to as acute respiratory infections and similar diseases.

Signs similar to acute respiratory infections

Treatment

The medications used in the treatment of pyelonephritis have high antibacterial properties and ensure the elimination of all by-products and harmful products of infectious or bacterial contamination in the urine. Antibiotics and antiseptics of natural origin, such as monural and nolicin, are widely used.

The basis of antibacterial treatment is considered to be antibiotics, derivatives of semi-synthetic penicillin, destroying E. coli, which in 85% of cases is considered the cause of inflammatory diseases of the urinary system.

If pathogens are resistant to antibiotics, drugs are used in conjunction with lactomase acid, which has high nephrotic toxicity. In addition to drugs monural and nolicin, research in the field of nephrology has shown the high efficiency of the use of such groups of drugs as fluoroquinolones and nitrofurans.

In terms of their action, they are similar to extended-range antibiotics. Unfortunately, these drugs have a very large number of contraindications and negative side effects.

Monural

The drug Monural

It is a broad-spectrum antibiotic based on phosphonic acid. The action of the drug is based on the suppression of the reproduction mechanism of pathogenic mechanisms already in the first stages of the disease. When taken, Monural is very quickly absorbed into the gastrointestinal tract and has a strong antibacterial effect on all groups of causative agents of urinary tract infections.

Monural has established itself as such an effective remedy that the course of treatment with the drug is only one day; for adults, Monural is recommended in doses from 2.5 to 3.5 grams one time. If Monural is prescribed for disinfection of the urinary tract after surgery, then it is taken for two days at a dosage of 2 grams per day.

If the patient has renal failure, then the dosage is reduced, and the interval between doses is increased. During the period of taking the medicine, you should drink plenty of fluids.

Monural is contraindicated in children under 4 years of age. For children under 10 years of age, the drug is prescribed only for a single dose in a dose not exceeding 2 grams. Before taking the granules of the drug, monural is preliminarily dissolved in 100 grams of boiled warm water, the resulting solution is drunk on an empty stomach before meals. It is recommended to empty the bladder before taking.

Monural (tablets) has a small range of contraindications. With the exception that the drug is recommended for use during pregnancy only in exceptional cases, it can cause heartburn, nausea and, in rare cases, diarrhea.

In addition to the treatment of pyelonephritis, Monural is widely used in the treatment of other infectious diseases - bacterial cystitis, infectious urethritis, for disinfection of the urinary tract after an operation (surgical) intervention, postoperative urinary tract infection in pregnant women.

Nolitsin

The drug Nolitsin

Nolitsin is an extended-spectrum antibacterial drug, belongs to the antibiotics of the fluoroquinolone group. Nolitsin has a powerful antibacterial effect on the urinary system.

The mechanism of action of the drug nolicin (injections and tablets) is based on the stimulation of bacterial enzymes that prevent the reproduction of pathological microorganisms and the achievement of instability of bacterial DNA. Destabilization of the DNA chain of bacteria leads to their death. Possesses a wide spectrum of antibacterial action.

When taken orally, nolicin is not completely absorbed, but only by about 30%, therefore it is recommended to take it on an empty stomach, at least 2 hours after a meal and be sure to drink plenty of liquid. The course of treatment for pyelonephritis or acute cystitis is from one to two weeks, and the dosage for adults is prescribed at 350-450 m / gram twice a day.

If the disease is of a permanent chronic nature or frequent relapses of the disease occur, nolicine is taken from three to six months at a dosage of 250-300 m / gram once a day, preferably before bedtime and always on an empty stomach.

Sometimes the drug (injections and pills) can cause bouts of vomiting, so it is recommended to drink very abundantly with warm boiled water. When taking the drug nolicin, you can add a few drops of lemon juice to the water, which contributes to better absorption of the drug.

Antibacterial drug

Nolitsin has a number of side effects and contraindications, which include nausea, vomiting, impaired urination, diarrhea, loss of appetite, heartburn. In more severe cases or in overdose, nolicine can cause arrhythmias, convulsions and sweating, headache, and dizziness. In case of an overdose, the patient should be placed on a stationary treatment regimen or copious gastric lavage with plenty of water.

The effect of the drug nolicin on women during pregnancy has not yet been sufficiently studied, therefore, a specialist, when prescribing this drug, should assess the need and possible benefits of treatment for the mother and the risk to the fetus.

During lactation, the use of the drug for the treatment of kidney pyelonephritis is not recommended, or the newborn should be transferred to artificial feeding. During the period of taking the medicine, you should drink plenty of fluids.

What pills to drink with kidney pyelonephritis?

Kidney inflammation is quite common in women and children. Conservative therapy involves the use of antibacterial agents and medications that have a diuretic effect. The most effective antibiotics are considered to be aimed at suppressing the activity of a certain type of bacteria. Broad-spectrum drugs also give good results, however, the uncontrolled use of drugs of this kind can lead to a violation of the intestinal microflora and increase the resistance of bacteria that provoked inflammation.

Vitamin therapy takes a special place in treatment. The patient is offered multivitamin complexes, as well as foods rich in vitamins C, P and B. For the period of treatment, it is recommended to adhere to a special diet. The emphasis is on dairy and vegetable nutrition, it is also allowed to eat boiled poultry and fish.

It is useful to drink berry fruit drinks and decoctions based on herbs that have a diuretic effect. In acute pyelonephritis, broad-spectrum drugs are often used. In chronic inflammation, the disease should be treated with drugs of a narrow profile, based on the sensitivity of the pathogen and its type. Since chronic inflammation can result from any kind of infection, antifungal and antiviral formulations may be required for treatment.

Antibacterial agents

Since in most cases the causative agents of infection are microbial associations, the patient is more often offered broad-spectrum agents. In the treatment of pyelonephritis of various nature, the following remedies have proven themselves well:

... has a powerful bactericidal effect, belongs to the group of penicillins. Effectively copes with bacterial lesions of the genitourinary sphere, is recommended for the prevention of complications, including in the postoperative period. Amoxiclav is administered intravenously three times a day, that is, every 8 hours. In severe conditions, Amoxiclav can be administered every 6 hours. Contraindications to the use of the remedy are jaundice and individual intolerance. During pregnancy, Amoxiclav can only be used for vital reasons. The drug is also suitable for children at the rate of 30 mg per 1 kg of the child's body weight.

Monural... Effective for pyelonephritis and bacterial cystitis. It is offered in the form of granules for the preparation of oral solution. Suitable for treating children over 5 years old. Monural should not be used in case of renal failure and hypersensitivity. In childhood, the drug is taken once in a dosage of 2 g. With caution, Monural should be taken in diabetes mellitus, since the drug contains sucrose. Monural is active against the vast majority of gram-positive microorganisms. Often, a single dose of the drug is sufficient, however, in case of purulent lesions or the presence of complicating factors, Monural can be recommended again 24 hours after the first application. The granules are dissolved in 1/3 cup of water and drunk on an empty stomach. The risk of overdose when using Monural is minimal.
Suprax. Available in granule or capsule form. It belongs to the third generation antibiotics of the cephalosporin series. Suprax is recommended for uncomplicated infections and inflammation of the urinary tract. The daily dosage is 400 mg for adults and children over 12 years of age and weighing over 50 kg. The average duration of therapy is 7-10 days. For streptococcal infections, it is recommended to take Suprax for at least 12 days. For the treatment of children and patients with renal insufficiency, it is recommended to take the agent in the form of a solution, which is made by dissolving the granules in water. Suprax can be used for babies from 6 months. The drug is prescribed in a dosage of 4 mg per 1 kg of body weight every 12 hours. In case of severe renal dysfunction (CC ≤20 ml / min), Suprax is offered in a half dosage. In case of an overdose, problems from the gastrointestinal tract are possible. Suprax is not recommended during pregnancy, however, in conditions close to critical, the use of this medication is permissible. Among the side effects of the antibiotic: allergic reactions, dry mouth, vomiting, dizziness, acute renal failure. In some patients, after using the Suprax remedy, shortness of breath, headache, dysbiosis, holistic jaundice and some others are noted.
Sulperazon... It is used intravenously and intramuscularly. It resembles Suprax in its action. It has similar indications and contraindications, as well as an extensive list of side effects. The dosage and duration of antibiotic use are determined by the doctor, based on the complexity of the disease and the age of the patient.

... It has a powerful effect, not recommended for use during pregnancy and under the age of 14 years. The drug is offered in the form of capsules for oral administration. It has a wide range of contraindications and side effects, which is why it is inferior to such drugs as Monural and Supraks.
Anaerstsev... Refers to antibiotics of the second generation. It is offered in the form of a powder for the preparation of a solution for injection. It is recommended for the treatment of pyelonephritis and other infections of the urinary system. One of the most popular remedies, which is also widely used as Monural and Suprax drugs.
Ampicillin... Semi-synthetic antibiotic, which is offered in the form of tablets, powder for solution for injection, capsules. The tablets are taken 3-4 times a day, depending on the concentration. The drug can be recommended for the treatment of children over 1 month of age. Tablets are often prescribed for infections of any kind, including genitourinary and musculoskeletal infections. Medicines of this kind have a wide range of applications, however, many doctors question their effectiveness in severe inflammation and offer more effective remedies, such as Monural.

If you have multiple pathogens, your doctor may recommend several antibiotics that can enhance each other's healing effects.

Herbal preparations

A special place in the complex therapy of pyelonephritis is occupied by herbal preparations. One of the popular remedies for disruption of the urinary system is Kanefron... The medicine is based on herbal ingredients: lovage, centaury herb, rosemary leaves. Canephron in chronic pyelonephritis gives good results in restoring kidney function. For children, the remedy is offered in the form of an oral solution. The tool effectively relieves inflammation and eliminates spasm.

If it is impossible to carry out a full-fledged antibacterial therapy, a single dose of the "Monural" agent and adequate therapy using herbal preparations are provided. Means such as have proven themselves well:

Uroflux... It has an antiseptic effect, suitable for the treatment of pyelonephritis and inflammation of the bladder. The tool has a slight diuretic effect and helps to restore the functions of the urinary organs. Among the components of the collection: bearberry, birch leaves, field horsetail, willow bark, licorice root, etc.
... It is offered in the form of a paste for preparing a suspension. The remedy is suitable for the treatment of pyelonephritis, but it is not recommended for use in glomerulonephritis. Refrain from using the drug will have to be in case of heart failure, pathological renal dysfunction and phosphate urolithiasis. The drug development has a diuretic effect and accelerates the elimination of other drugs, which should be remembered during the period of therapy.

It is useful to take herbal decoctions containing the following ingredients: elderberry, elecampane, birch leaves, corn silk, wheatgrass, chamomile.

Aids

It is possible to treat the disease only with the use of antibiotics. No other therapy for pyelonephritis is provided, except in cases where the use of antibacterial drugs is unacceptable. In this case, the emphasis is on anti-inflammatory therapy and the use of detoxification agents. The patient is offered diuretic teas, renal charges, multivitamin complexes. Immunomodulatory therapy allows you to speed up the restoration of the functions of the urinary organs and the general improvement of the body.

It is acceptable to treat kidney inflammation with common physiotherapy methods. Electrophoresis in the kidney area stimulates metabolic processes and accelerates the regeneration of damaged tissues. To relieve inflammation, solutions of furadonin, erythromycin or calcium chloride are usually used.

With the development of anemia, iron-containing agents are indicated... To improve renal blood flow, drugs such as Traxevasin, Heparin, Trental are recommended. They have a mild diuretic effect, promote oxygenation of the kidneys, and restore blood circulation.

According to the indications, cardiac drugs, antispasmodic and hypotensive compounds can be prescribed, which are used for pyelonephritis against a background of high blood pressure.

To reduce the likelihood of relapses in chronic pyelonephritis, anti-relapse therapy is indicated, which includes taking antibacterial and antiseptic agents, active immunomodulatory therapy, taking medications and diuretic tea.

In the absence of an exacerbation for more than 3 months, it is recommended to take uroantiseptics of plant origin with a frequency of 1 time per month for 7-10 days.

For a faster recovery and reduce the likelihood of recurrence in chronic inflammation of the kidneys, it is recommended to use rosehip decoction, infusion of juniper fruits, cranberry juice, decoction of birch leaves. For preventive purposes, Kanefron-N can also be recommended, which is often prescribed during pregnancy.

Chronic pyelonephritis how to treat it what medications. What pills can treat pyelonephritis

Pyelonephritis treatment: what drugs

Diet for pyelonephritis

Essential antibiotics for treating kidney inflammation

Empiric treatment of pyelonephritis: starting antibiotics

What diuretics are used to treat pyelonephritis

Treatment methods

Antibiotics

Herbal preparations

Basic concepts

Classification

Clinical manifestations

Diagnostics

Treatment

Drug therapy

Principles of therapy

Performance criteria

Blood pressure control

Preventive actions

Antibacterial drugs

Anti-inflammatory and antispasmodic drugs

Diuretics

Fluoroquinolones

Sulfonamides

Treatment methods

Antibiotics

Herbal preparations

Why are antibiotics effective in fighting pyelonephritis?

Benefits of antibiotics over herbal remedies and other medications

Antibacterial agents for the treatment of pyelonephritis

Diagnostics

Treatment

Monural

Nolitsin

Antibacterial agents

Herbal preparations

Aids

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