Bactrim for kidney infection treatment

Kidney Infection Treatment

Treatment for Kidney Infection

Kidney infections are treated using antibiotics to destroy the bacteria. The type of antibiotic used varies, depending on the type of bacteria that is causing the infection. Commonly-prescribed antibiotics include Amoxil, Cipro, Levaquin, and Bactrim.

Patients generally take antibiotics for one to two weeks. Symptoms caused by minor infections may begin to improve after a couple of days, but severe infections often take longer.

To help reduce symptoms while recovering from a kidney infection, patients can apply heat to the affected area and/or take pain relievers. Aspirin is not recommended. Drinking plenty of fluids helps remove bacteria from the urinary tract and also may be helpful.

Other Kidney Infection Treatments

If a kidney infection does not respond to antibiotics, or if the condition recurs, physicians often check for urinary tract abnormalities. Intravenous antibiotics or surgery may be required. Severe kidney infections may require lengthy hospital stays and antibiotics for up to six weeks.

Kidney Infection Follow-up

If the kidney infection does not improve as expected, follow-up care with a physician may be necessary. In some cases, a change in antibiotic and/or additional tests (e.g., to detect complications) are required.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 03 Jun 2007

Last Modified: 22 Sep 2015

MONDAY, Jan. 14, 2002 (HealthDayNews) — If you’re a woman taking antibiotics for a urinary tract infection, chances are you’re not on the drug that experts say you should be using.

A new study says three in four women don’t receive Bactrim, the recommended front-line medication to control urinary tract infections (UTIs), which are a common bacterial ailment that affects millions of American women each year.

Although the other prescriptions aren’t likely to affect patient care in the short run, the researchers say their use could promote drug resistance that may make UTIs much harder to treat in the future.

“Doctors make decisions on antibiotic use right then and there” for individual patients, says Dr. Elbert Huang, a University of Chicago researcher who was co-author of the study. “Their choice may be right for that person, but for society as a whole, it may be the wrong choice.”

What’s more, adds Huang, whose study appears in today’s Archives of Internal Medicine, the first choice drug also happens to be the cheapest therapy. By ordering more expensive treatments, doctors are needlessly driving up health care costs. A recent study by government researchers showed that prescription drug spending rose by more than 17 percent in 2000, to almost $122 billion.

In 1999, the Infectious Disease Society of America set guidelines on the best way to treat uncomplicated urinary tract infections in women. The guidelines came from a 1993 paper the society published. According to the policies, doctors should first prescribe a drug called trimethoprim-sulphamethoxazole, or Bactrim. As a second line of defense, certain members of the potent but much more expensive fluoroquinolone class, which includes Cipro, can be used.

But Huang and his colleagues found that doctors are increasingly eschewing Bactrim for fluoroquinolones and even a third-tier drug called nitrofurantoin.

The researchers examined almost 1,500 outpatient visits for UTIs and bladder infections between 1989 and 1998. In the first year of the study, 48 percent of prescriptions were for trimethoprim; by 1998, those prescriptions had dropped by half. In the same time frame, the orders for fluoroquinolones prescriptions jumped from 19 percent to 29 percent, while those for nitrofurantoin rose from 14 percent to 30 percent.

What drug a woman received depended largely on the kind of doctor she saw. Internists, for example, were more likely to adhere to the infectious disease guidelines. But obstetricians and gynecologists favored nitrofurantoin over Bactrim and fluoroquinolones, which have been linked to birth defects.

Huang considers that preference “legitimate,” and acknowledges that some of the choices likely considered other important factors like patient medication allergies. Yet he and his colleagues suspect that most of the reason doctors haven’t followed the guidelines involves drug company marketing and promotion practices, not which pill works best. “Over the decade that we watched, there was really no change in terms of new trials showing that fluoroquinolones were better than Bactrim,” he says.

Dr. Randall Stafford, a Stanford University researcher and co-author of the study, says many doctors choose broadly acting antibiotics for UTIs because they’re looking for the biggest fly swatter available. “Some physicians prefer to use an antibiotic that’s going to work no matter what,” Stafford says. Yet some of the impetus for ordering heavyweight compounds also comes from patients, he says.

While urinary tract bacteria might not notice the difference between Bactrim and Cipro, the health care system certainly does. The first compound costs less than $2 for a 10-day supply, compared with as much as $70 for the same amount of Cipro. Generic nitrofurantoin falls in between, at about $20 for the 10-day regimen.

In other words, with 2.45 million prescriptions written annually for UTIs, the decision not to use Bactrim as the first-line therapy for UTIs can cost patients or health insurers tens of millions of dollars in unnecessary charges, the researchers say.

If that’s not a sufficient deterrent to follow the infection society’s recommendations, Huang says failure to do so may ultimately make treating UTIs far more difficult. Spreading the burden of killing the disease-causing bacteria over several drugs promotes resistance to each of them concurrently.

A better approach, and the one experts advise, is to use a single drug — in this case Bactrim — until it works no more. “The idea is that we push the envelope as far as we can with a single agent, thus preserving the efficacy of other drugs,” he says.

Dr. James R. Johnson, a University of Minnesota physician who helped write the 1999 UTI treatment guidelines, says bugs resistant to Bactrim and its near relatives have become more common. So the increase in prescriptions for other drugs isn’t necessarily concerning. On the other hand, he adds, “it would be a mistake” if doctors were offering their patients stronger medications without knowing they were infected with resistant organisms.

Johnson considers the surge in fluoroquinolone use particularly alarming, since losing these drugs to resistance would be a major setback for infection control in general. As a result, he says, it’s probably wiser to use nitrofurantoin as the runner-up to Bactrim for urinary infections.

What To Do

To find out more about urinary tract infections, try the National Institute of Diabetes and Digestive and Kidney Diseases or MEDLINEplus.

You can also visit the UrologyChannel.

Can You Treat a Kidney Infection at Home?

Some people prefer to treat medical conditions with home remedies or alternative remedies.

Because of how serious kidney infections are, it’s important that you don’t rely on home remedies. Instead, you should take the prescription antibiotics your doctor gives you and use home remedies to help ease symptoms or pain. You can also use home remedies to avoid UTIs and improve kidney function.

1. Drink lots of water

Drinking plenty of water can help flush bacteria from the body, helping the infection to be eliminated faster. It can also help clear out the entire urinary system.

Drinking plenty of water can also help to prevent UTIs that can lead to kidney infections, so it’s a good practice to keep. Aim to drink at least eight glasses of fluids daily.

2. Drink cranberry juice

Cranberry juice has long been used as a remedy for UTIs and bladder infections. There’s some evidence that drinking cranberry juice may help or prevent UTIs in some people.

Many people prefer the sweet flavor of cranberry juice to water, helping them to drink more. However, cranberry juices full of added sweeteners aren’t great for you. A cranberry supplement or pure cranberry juice is a healthier way to get the benefits of cranberries.

3. Avoid alcohol and coffee

The kidneys’ most important role is to filter out harmful substances and toxins, and both alcohol and caffeine can require extra work from the kidneys. This may hinder the process of healing from an infection. Alcohol and antibiotics also shouldn’t be mixed, so avoid alcohol during your treatment for this reason as well.

4. Take probiotics

Probiotics have two big benefits when it comes to treating kidney infections. The first is that they’ll help keep your body’s healthy bacteria in check, even though the antibiotics may get rid of both “good” and “bad” bacteria.

There’s also evidence that probiotics can assist the kidneys in processing waste materials, and the better your kidneys are functioning, the more effective treatment will be.

5. Get some vitamin C

Vitamin C is a powerful antioxidant that helps protect tissues in the body from oxidative stress, which can automatically help promote kidney health. There’s also older research that shows that vitamin C can prevent kidney scarring during acute kidney infection and boost the enzymes within the kidneys. You can take vitamin C supplements or foods dense in the nutrient.

6. Try parsley juice

Parsley juice is a nutrient-dense diuretic that can increase the frequency and amount of urination. This can help flush out the bacteria in the kidneys faster, making antibiotics even more effective. If you don’t like the taste of parsley outright, you can mix it into a smoothie with strong-flavored fruits, including cranberries or blueberries for best results.

7. Consume apples and apple juice

Apples are also nutrient-dense. Their high acid content may help the kidneys to maintain acidity in the urine, possibly inhibiting further growth of bacteria. They also have anti-inflammatory properties, which may be beneficial in helping the kidneys to heal following the infection. Learn more about the many health benefits of apples.

8. Take an Epsom salt bath

Both Epsom salts and warm water can ease pain. This can help to make the uncomfortable side effects of the kidney infection a little more tolerable while you wait for the antibiotics to take effect.

Since abdominal pain is sometimes a symptom of antibiotics, as well as kidney infections, this could also help even after symptoms from the kidney infection are resolved. Read about how to make an Epsom salt detox bath, as well as potential side effects to keep in mind.

9. Use non-aspirin pain relievers

Non-aspirin pain relievers can help to relieve discomfort. Ibuprofen, including Motrin and Advil, as well as acetaminophen (Tylenol) can also help break fevers caused by the infection.

10. Apply heat

While you wait for the antibiotics to kick in, you can use heat therapy to reduce pain. Apply a heating pad or hot water bottle to the affected area, and keep it on for about 20 minutes at a time.

What Antibiotics are Used for a Kidney Infection?

Table of Contents

Curing kidney infections always requires antibiotics to prevent bacteria from multiplying. Medically known as pyelonephritis, kidney infections are a result of bacteria entering the kidneys, most commonly from a pre-existing infection in the urinary tract like a bladder infection. Depending on the severity of the infection and type of bacteria, different types of kidney infection antibiotics are used as the first line of defense.

Read on to understand what a kidney infection is and learn about the different types of antibiotics and over the counter medicine for kidney infections below.

What is a Kidney Infection?

Kidney infections are a result of bacteria entering the kidneys, most commonly from a pre-existing infection in the urinary tract, like a bladder infection. The urinary tract or urinary system is made up of organs designed to extract, hold, and transport waste from your system in the form of urine. These organs include:

  • Two kidneys: that process our blood by filtering out the waste to produce urine before releasing the “clean” blood to be recirculated in the body
  • Two ureters: that transport urine between the kidneys and bladder
  • A bladder: that stores urine until it is released during the urination process
  • A urethra: connected to the bladder and genitals for releasing urine

When bacteria travel to the bladder after entering the urethra, they can use stored urine as food to grow. Multiplied bacteria can cause bladder infections that can migrate to the kidneys and result in a kidney infection.

The most common bacterium that causes urinary tract infections is Escherichia coli, which you might know better as simply E. coli. Responsible for about 90 percent of all uncomplicated urinary tract infections, E. coli can be found in the colons of humans and animals and in their fecal waste.

Kidney Infection Symptoms and Signs

A urinary tract infection (UTI) generally starts in the bladder and the signs and symptoms of a bladder infection may remain the same even after the infection spreads to the kidneys.

These indicators include:

  • Cloudy and dark urine that may appear red or pink from blood
  • Painful or burning urination
  • Foul-smelling urine
  • Pain in the abdomen
  • High temperature that remains under 101° Fahrenheit.

When the infection has spread to the kidneys the following additional indicators can be expected:

  • High temperature that exceeds 101° Fahrenheit
  • Nausea
  • Vomiting
  • Chills and shaking
  • Back and flank pain

Generally, kidney infection symptoms will feel worse during urination. A significant change to your usual pattern of urination accompanied with common signs and symptoms of kidney infection are good indicators to contact your doctor.

Treatments for Kidney Infections

While there are various kidney infection treatment options and considerations, the process will typically require antibiotics.

Usually, doctors will prescribe empiric antibiotics for at least a full week. These cover all the bases of potential bacteria that initially caused the infection until they can target the specific bacteria strain responsible.

If you can move around and keep down oral antibiotics you will normally not require a stay in the hospital. Patients at higher risk of infections worsening or those exhibiting severe symptoms, including not being able to keep medication down due to vomiting, will generally require hospitalization. At the hospital, doctors can administer antibiotics and fluids intravenously.

Serious treatment is required when infections progress to create a kidney abscess. Abscesses cannot be cured with antibiotics alone and will need a nephrostomy to drain them, which is when a tube is put through the skin into the kidney to drain the fluid out the abscess.

People with structural issues in the urinary tract often need surgery to prevent reoccuring kidney infections.

Types of Kidney Infection Antibiotics

People often want to know what antibiotics are used for kidney infection. There are many types of over-the-counter medicines for kidney infections that treat the illness in different ways depending on the:

  • Severity of the case
  • The bacteria involved
  • The patient’s history, including medication allergies

Don’t rely on home remedies alone to take care of kidney infections, as bacteria growth can lead to worsening symptoms. More information on the main types of antibiotics administered is listed below.


Amoxicillin belongs to the penicillin group of drugs and is a widely used antibiotic to treat infections caused by bacteria.

Using amoxicillin for a kidney infection will prevent more bacteria from growing as well as kill off the existing bacteria. It is generally taken twice a day.

Amoxicillin is also a common drug used to treat bronchitis, pneumonia, and to prevent chlamydia during pregnancy.

Amoxicillin is safe for pregnant women and can prevent bacterial infection in newborns. It can be taken orally, as a dry tablet, chewable tablet, capsule, or liquid preparation.

It is important to note that amoxicillin can reduce the effectiveness of certain birth control measures such as patches, the pill, and rings. It has also been known to cause false positive results in urine glucose tests.

Common side effects to be aware of when taking amoxicillin for kidney infection are:

  • Diarrhea
  • Hyperactivity
  • Tooth discoloration.

Allergic reactions to this medication will come with side effects such as:

  • Chest tightness
  • Difficulty breathing
  • Hives
  • Swelling of the face or throat.

More serious and uncommon side effects that may occur include:

  • Unusual bleeding or bruising
  • Seizures
  • Yeast overgrowth called candidiasis. (To read about yeast infections caused by antibiotics click here)


Bactrim belongs to the sulfa drug class and is considered an antibacterial agent. Taking bactrim for kidney infection will reduce the number of bacteria in the urinary system.

Common side effects to be aware of when taking bactrim for kidney infection include flu-like symptoms such as:

  • Nausea
  • Vomiting
  • Headaches
  • Changes in bowel function

Severe allergic reactions to this medication will include:

  • Rashes
  • Itching
  • Swelling

Although less common, serious side effects such as liver damage or lung injuries may occur. Anyone with liver or kidney disease or with any metabolic disorder is not recommended to take bactrim for kidney infections.


Cephalexin belongs to a class of antibiotics known as cephalosporins. It works by damaging the cell walls of bacteria, causing them to die off.

This medication is not recommended for pregnant and nursing mothers or for patients with kidney disease or those who have suffered kidney failure.

Common side effects to be aware of when taking cephalexin for kidney infection include:

  • Flu-like symptoms
  • Headaches
  • Vomiting
  • Nausea
  • Hives
  • Swelling of the throat
  • Difficulty breathing
  • Itching and peeling of the skin
  • Severe diarrhea.


Cipro is part of the fluoroquinolones class of antibiotics and can be taken in tablet or liquid form. Choosing cipro for kidney infection treatment can be a good option if you have certain health conditions such as myasthenia gravis or risks of seizures.

It is considered a category C pregnancy drug; pregnant women should talk to your doctor about whether it is safe for you. This includes consulting a doctor on whether you should take a different antibiotic if breastfeeding as it may pass to a child through breast milk.

Common side effects to be aware of when taking cipro for kidney infection include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Rashes
  • Changes to liver function


Clindamycin is from the lincomycin class of antibiotics and, because of its side effects, should only be used to treat serious infections that cannot be treated by other antibiotics. Taking clindamycin for kidney infection works by stopping or slowing the growth of bacteria cells. Clindamycin comes in capsule and liquid form to be taken orally, usually for three to four times a day.

Clindamycin is the most likely than many other antibiotics to cause overgrowth of dangerous bacteria in the large intestine. This can lead to diarrhea or colitis, which is a life-threatening condition of inflammation in the large intestine.

Other side effects to be aware of when taking clindamycin for kidney infection include:

  • Nausea
  • Vomiting
  • Joint pain
  • Heartburn
  • Irritation of the vagina

Other serious side effects include:

  • Blisters
  • Rash
  • Hives
  • Yellowing of the skin or eyes.


Levaquin is a member of the fluoroquinolones drug class and works by reducing the bacteria in the body. It is typically taken once daily.

Levaquin is not recommended for pregnant and breastfeeding women.

Potential side effects to be aware of when taking Levaquin for kidney infection include:

  • Swelling of tendons in the body
  • Damage to the liver
  • Change in blood sugar levels
  • Change in heart rhythm

This medication is not recommended if you have:

  • Kidney failure
  • Liver disease,
  • Rheumatoid arthritis
  • Low blood potassium
  • Irregular heartbeat

Although the symptoms and signs of a kidney infection will often improve within a few days of starting an antibiotic, be sure to finish the medication as prescribed by your doctor.

Prior to obtaining medication, be sure your doctor is aware of any previously diagnosed illnesses and has a comprehensive list of all medications, vitamins, and minerals you are taking. This can help doctors access intake and prevent any medication contradictions from occurring. Make sure to also contact your doctor if infections do not clear up or any symptoms of medication side effects occur.

Other Urinary Tract Antibiotics

There are other antibiotics that may be administered for urinary tract infections but are not specifically for treating kidney infections. For instance, Macrobid is specifically for treating bladder infections and should not be used for kidney infections even though it reduces the growth of bacteria in similar ways that kidney infection antibiotics will. Make sure you consult your doctor to confirm where the infection is located along the urinary tract before deciding between macrobid or kidney infection antibiotics.

Preventing a Kidney Infection

There are many preventative care options and home remedies that can be used to reduce kidney infection symptoms and prevent recurring infections. Generally, these methods involve reducing the likelihood of bacteria entering the urinary tract and developing into an infection. Major methods beyond dietary considerations and proper hygienic routines when wiping include:

  • Don’t hold urine and try to completely empty your bladder without rushing anything
  • Urinate soon after sex, and make sure you practice safe sex in general
  • Switch to a different birth control method if you currently use a diaphragm, since it prevents proper and complete emptying of the bladder

If you experience any symptoms of a urinary tract infection or kidney infection, call or book an online appointment with PlushCare to see a top U.S. doctor today.

Read more of our Kidney Infection and UTI Series:

  • Signs and Symptoms of a Kidney Infection
  • When Does a UTI Turn Into a Kidney Infection?
  • Difference Between a Kidney Infection and UTI

Article Sources

What is Kidney (Renal) Infection – Pyelonephritis?

Many problems in the pelvis and abdomen can cause symptoms that look like kidney infection. Your doctor will want to diagnose your problem correctly to learn what’s happening and find the best treatment.

To diagnose the problem, your health care provider may use the following tests:

  • A medical history. You will be asked questions about your symptoms, when they began, and about your general health history.
  • Physical exam. You will receive a general medical exam to collect blood and urine samples. The doctor will likely press your abdomen to check for pain or tenderness.
  • Urinalysis. A sample of your urine will be tested to look for signs of infection. High counts of white blood cells and bacteria mean that there is an infection.
  • Urine culture. In a urine culture, bacteria in urine may grow on a culture dish within a few days. This information will help the doctor determine the best antibiotic to use.
  • Blood cultures. A blood culture can tell if your infection has spread to your blood.
  • Computed tomography (CT scan). A CT scan is not necessary to diagnose kidney infection, but it shows detailed 3D images of the urinary tract and kidneys to detect problems. A CT would also see if there is a blockage that needs treatment.
  • Kidney ultrasound. Ultrasound can create images of the kidneys and ureters to show if there are wounds, stones, or other things that block the urinary tract. This information can help guide treatment decisions.
  • Voiding cystourethrogram (VCUG) is an x-ray image of the bladder and urethra taken while the bladder is full and during urination. It uses a contrast dye. This test can show problems in the urethra and bladder.
  • Digital rectal examination (DRE). A DRE is a physical exam of the prostate. Men who may have kidney infection may have a DRE to see if a swollen prostate is blocking the neck of the bladder.
  • Dimercaptosuccinic acid (DMSA) scintigraphy. This test uses small amounts of a radioactive material to look closely at how well the kidneys work. Special cameras and computers create images to see if the kidneys are infected, scarred or damaged.

Your doctor will also look for problems that can cause kidney infection, such as kidney stones or birth defects. These things can be treated to prevent future infections. Your treatment will be based on a clear diagnosis of the problem.

This leaflet only deals with sudden-onset (acute) kidney infection in adults. The medical term for this is acute pyelonephritis. There are separate leaflets on related topics, Cystitis (Urine Infection) in Women, Urine Infection in Pregnancy, Urine Infection in Men, Urine Infection in Children and Urine Infection in Older People. Also, this leaflet does not deal with chronic pyelonephritis, which is a condition where the kidney is scarred as a result of repeated infections.

Understanding the kidneys and urinary tract

There are two kidneys, one on each side of the tummy (abdomen), towards the back. They make urine which drains down the tubes between the bladder and kidney (ureters) into the bladder. Urine is stored in the bladder and is passed out through the tube from the bladder (the urethra) from time to time when we go to the toilet.

What causes a kidney infection?

Most kidney infections develop from a bladder infection (cystitis). Bacteria travel up the tube between the bladder and kidney (ureter) to infect a kidney. These bacteria are usually those normally living in the bowel – eg, E. coli. Most people with cystitis don’t get a kidney infection.

Some kidney infections develop without a bladder infection. This is sometimes due to a problem in the kidney. For example, people are more prone to kidney infections if they have a kidney stone or an abnormality of the kidney.

It is usually only one kidney that develops an infection. A kidney infection can occur at any age. It is much more common in women. This is because women are more at risk of developing a bladder infection (which can spread to the kidneys). In women, the urethra is closer to the anus, which makes it easier for bacteria to get from the bowel to the urethra. The urethra is also shorter in women than in men, so bacteria can reach the bladder more easily.

Kidney infections are also more common in children, in older people and during pregnancy. They are uncommon in men.

What are the symptoms of a kidney infection?

Symptoms usually develop quickly, over a few hours or so, and may include:

  • Pain in a loin or flank. (This is the area at the side of your back where the kidney is located).
  • High temperature (fever) which may cause shivers.
  • Feeling sick (nausea) and/or being sick (vomiting).
  • Diarrhoea.
  • Blood in the urine.
  • There will also usually be symptoms of a bladder infection – for example, pain on passing urine, and going to the toilet often.

Not all of the symptoms may develop, and sometimes a kidney infection can just cause vague symptoms. For example, just feeling generally unwell but not being able to say why.

In older people a kidney infection may cause confusion. This is why a urine test is often done when an elderly person suddenly becomes confused or appears generally unwell.

Do I need any tests?

A simple test that your doctor can do is called a dipstick urine test. This involves testing a sample of your urine with a special testing strip to look for signs of infection. This test will show if a kidney infection is likely or not.

However, it is important to confirm the diagnosis and also to find out which germ (bacterium) is causing the infection. This will enable a doctor to prescribe the correct antibiotic. For this, your doctor will need to send your urine sample to the laboratory so that the bacterium can be identified and tests can be done to see which antibiotics will kill it. As this may take some days for the results, treatment is usually started straightaway.

A urine sample may be the only test that is needed if you are a woman who is otherwise healthy, but develop cystitis which progresses to a kidney infection. Further tests may be advised in some situations – for example, if you have a kidney stone or if a kidney abnormality is suspected. Tests are also usually advised if you are a man, or if you have recurring kidney infections. If further tests are needed, an ultrasound scan is often the first one which is done.

What is the treatment for a kidney infection?

  • Antibiotics will usually clear the infection. An antibiotic is usually prescribed straightaway if a kidney infection is suspected, even before the result of the urine test is known. Some germs (bacteria) are resistant to some antibiotics. Therefore, sometimes a change of antibiotic may be needed if the urine test shows a germ (bacterium) which is resistant to the initial antibiotic. The course of antibiotics is for 7-14 days, depending on which one is used. Commonly used antibiotics for kidney infections include ciprofloxacin or co-amoxiclav. Trimethoprim is also sometimes used.
  • Painkillers such as paracetamol can ease pain and reduce a high temperature (fever). Stronger painkillers may be needed if the pain is more severe. Non-steroidal anti-inflammatory painkillers such as ibuprofen are not usually recommended for a person with a kidney infection. This is because they may possibly cause problems with the working of the kidney during a kidney infection.
  • Plenty of fluid should be taken to prevent lack of fluid in the body (dehydration).

In many cases, the infection is not too severe, treatment can be taken at home and the infection will clear with a course of antibiotic tablets. If treatment is to be home-based, a doctor should be called if the symptoms are not improving after 24 hours, or the person is feeling more unwell.

However, some people need to be admitted to hospital – for example if:

  • The infection is severe and causing them to be very unwell.
  • The person is unable to take any fluids or their medicines (due to being too unwell or due to vomiting).
  • Symptoms do not settle quickly with antibiotics.
  • The person is a pregnant woman.
  • The person is otherwise ill or frail.
  • The person has underlying kidney problems.
  • The person has diabetes.

In hospital, antibiotics can be given straight into the vein (intravenously) for a more immediate effect. If the person is dehydrated, they may also need a drip (where fluid is put straight into a vein).

Are there any complications from a kidney infection?

Most people who develop a kidney infection make a full recovery if treatment is given promptly. Possible complications which occur in a small number of cases include:

  • Sometimes germs (bacteria) from a kidney infection get into the bloodstream, particularly if treatment is delayed. This may cause blood poisoning (sepsis). This can be serious or even life-threatening.
  • In pregnant women who develop pyelonephritis occasionally it may result in the baby being born early or with a lower birth weight.
  • A kidney abscess can (rarely) develop. This is a collection of pus that forms within the kidney.
  • The infection can sometimes cause some permanent damage to kidney tissues.

These complications are uncommon but may be more likely if:

  • You become severely ill with the kidney infection.
  • You already have a problem with your kidneys, such as polycystic kidney disease or chronic kidney disease.
  • You have a condition where instead of just flowing one way, your urine can backtrack from the bladder back up to the kidney (vesicoureteric reflux).
  • You have kidney stones.
  • Your immune system is suppressed – for example, if you have cancer, if you are taking medication such as steroids or chemotherapy, or if you have AIDS.
  • You have poorly controlled diabetes.
  • You are an older person (over the age of 65 years).
  • You are pregnant.

Emphysematous pyelonephritis is also a rare complication. In this condition the kidney tissues are rapidly destroyed by the infection and the bacteria can release toxic gases which can build up in the kidneys. You become very unwell if you develop this complication. This complication seems mostly to affect people who have poorly controlled diabetes.

Can kidney infection be prevented?

Most kidney infections are caused by germs (bacteria) travelling up from a bladder infection. So the same things that can help to reduce your chances of bladder infection should reduce your chances of kidney infection. Traditionally, people who got recurring urine infections were advised about measures such as drinking plenty of fluid and taking cranberry juice, and on the way they wiped themselves after going to the toilet. However, there is little evidence for any of these measures and they are now not usually advised. Anything which increases your risk of urine infections which can be treated, should be treated. For example, any constipation should be treated promptly, as constipation can increase your chances of a bladder or kidney infection. See separate leaflet called Constipation in Adults for more details. Doctors will try to treat anything else which might be contributing, such as kidney stones or an abnormality in the structure of the urinary system.

Pregnant women are regularly tested for urine infections and for germs (bacteria) in their urine. Even if they don’t have symptoms, if urine tests positive for germs, pregnant women are usually treated with antibiotics to prevent any complications.

In some cases people who have recurring urine infections are treated with a low dose of antibiotic continually. This may help to prevent recurrences and to prevent spread to the kidney.

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