Empirical therapy for acute pyelonephritis in pregnancy

For the treatment of patients with sepsis or septic shock, see Sepsis and septic shock from a urinary tract source in adults.

See Rationale for empirical therapy for acute pyelonephritis in pregnancy for a discussion of antibiotic choice.

For the empirical therapy for pyelonephritis in pregnancy, while awaiting the results of investigations, use:

1gentamicin intravenously; see Gentamicin initial dose calculator for adults for initial dose. See Principles of aminoglycoside use for prescribing considerations and subsequent dosing. See advice on modification and duration of therapy gentamicin gentamicin gentamicin

OR

1tobramycin intravenously; see Tobramycin initial dose calculator for adults for initial dose. See Principles of aminoglycoside use for prescribing considerations and subsequent dosing. See advice on modification and duration of therapy tobramycin tobramycin tobramycin

PLUS with either of the above regimens

1amoxicillin 2 g intravenously, 6-hourly. For dosage adjustment in adults with kidney impairment, see amoxicillin dosage adjustment. See advice on modification and duration of therapy amoxicillin amoxicillin amoxicillin

OR

1ampicillin 2 g intravenously, 6-hourly. For dosage adjustment in adults with kidney impairment, see ampicillin dosage adjustment. See advice on modification and duration of therapy ampicillin ampicillin ampicillin

OR as a single drug

1ceftriaxone 1 g intravenously, daily. See advice on modification and duration of therapy. ceftriaxone ceftriaxone ceftriaxone

Ceftriaxone monotherapy (as above) may be preferred for patients in whom intravenous therapy is likely to continue for 72 hours or longer1, to avoid the need to switch to a non–aminoglycoside-containing regimen at 72 hours. Ceftriaxone is also recommended if the patient has contraindications or precautions that preclude aminoglycoside use.

For pregnant patients who have had a nonsevere (immediate or delayed) hypersensitivity reaction to a penicillin, use ceftriaxone (as above).

For pregnant patients who have had a severe immediate2 hypersensitivity reaction to a penicillin, ceftriaxone (as above) can be considered (for considerations, see Severe immediate hypersensitivity: Implications of cross-reactivity between penicillins and cephalosporins).

For pregnant patients who have had a severe immediate2 hypersensitivity reaction to a penicillin in whom ceftriaxone is not used, or for pregnant patients who have had a severe delayed3 hypersensitivity reaction to a penicillin, use gentamicin or tobramycin as a single drug and seek expert advice for additional antibiotics to ensure activity against Streptococcus agalactiae (group B streptococcus [GBS]).

1 If the likely duration of intravenous therapy is not known, it is preferable to start with an aminoglycoside-containing regimen and not delay administration of antibiotics.Return
2 Severe immediate hypersensitivity reactions include anaphylaxis, compromised airway, airway angioedema, hypotension and collapse.Return
3 Severe delayed hypersensitivity reactions include cutaneous adverse drug reactions (eg drug rash with eosinophilia and systemic symptoms [DRESS], Stevens–Johnson syndrome/toxic epidermal necrolysis [SJS/TEN], severe blistering or desquamative rash), and significant internal organ involvement (eg acute interstitial nephritis).Return