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Microbiology - Escherichia Coli (4169)
Mobeen Syed, MD - 2018-09-18 16:36:47

Treatment of Pyelonephritis

Uncomplicated:

  • Mild to moderate: Trimethoprim-sulfamethoxazole, fluoroquinolones (ciprofloxacin) (all usually oral)
  • Severe: Ceftriaxone, fluoroquinolones (ciprofloxacin, levofloxacin), trimethoprim-sulfamethoxazole (all usually intravenous)

Complicated

Indwelling urinary catheter, urinary obstruction or

retention, recent urologic procedure or hospital-acquired

infection, underlying renal impairment with azotemia, immunosuppression & comorbid diabetes. All are usually treated with hospitalization & intravenous antibiotics.

  • Mild to moderate: Ceftriaxone, cefepime, fluoroquinolones (ciprofloxacin, levofloxacin)
  • Severe: Ampicillin-sulbactam, ticarcillin-clavulanate, piperacillin-tazobactam, meropenem, imipenem, aztreonam (+/-gentamicin)

Pregnancy

Usually hospitalized for intravenous antibiotics

  • Ceftriaxone +/- gentamicin, aztreonam

Microbiology - Escherichia Coli (4169)
Mobeen Syed, MD - 2018-09-18 16:49:39

UW 4257. E Coli can also cause osteomyelitis in immunocompromised patients (diabetics for example.)

Escherichia coli and Klebsiella pneumoniae may cause osteomyelitis (especially in patients with diabetes mellitus), but both microorganisms are far less common than Pseudomonas in patients with puncture wounds.

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