Treatment options for pyelonephritis vary depending on the acute or chronic approach.

Nephritis is divided into acute nephritis and chronic nephritis. For acute nephritis, antibacterial treatment is the most important; for chronic nephritis, general treatment or special treatment can be performed. The specific treatment depends on the patient's condition.

1. Treatment of acute nephritis

Antibacterial treatment is the most important for acute pyelonephritis. For patients with obvious symptoms, antibiotics should be used immediately after taking urine samples for routine and bacteriological examinations. Generally, bactericidal antibiotics that are sensitive to Gram-negative bacteria and have high concentrations in urine and blood are preferred. Remember to drink plenty of water to increase urine volume and promote the excretion of bacteria and inflammatory secretions. Give a high-vitamin, high-calorie, easily digestible diet. When symptoms are obvious, the patient should rest in bed and receive intravenous fluids.

1. Lightweight

It is advisable to take antibacterial drugs orally for 14 days. Commonly used antibiotics include 2 tablets of sulfamethoxazole, twice a day, 0.2g ofloxacin, twice a day, 0.25g of ciprofloxacin, twice a day, or a single drug such as ampicillin and amoxicillin taken orally. Quinolone is the first choice.

2. More serious cases (often accompanied by fever, costovertebral angle pain, increased white blood cell count, etc.)

Antibiotics should be injected intramuscularly or intravenously, such as aminoglycoside antibiotics, cephalosporins, amoxicillin, etc.

3. Severe case (obvious systemic symptoms, 3-4 days of treatment with the above drugs, urine bacteria still cannot turn negative and symptoms worsen)

Use antibiotics, such as semi-synthetic broad-spectrum penicillins (piperacillin, thiabendazole penicillin, benzocaproic acid penicillin, etc.), in combination with aminoglycoside antibiotics or third-generation cephalosporins (such as cefotaxime, ceftriaxone, ceftriaxone, etc.). Depending on the specific situation, 2 to 3 antibiotics can be selected and used in reasonable combinations.

Generally, after the above-mentioned antibacterial treatment, the symptoms will improve after 24 hours. If it is still ineffective or worsens after 72 hours, the medication should be changed or combined, and drug sensitivity tests should be referred to and adjusted in combination with clinical practice. The course of antibiotics is usually 10 to 14 days. Urinalysis and urine bacteria should be rechecked one week and one month after stopping the medication. Only those who are negative in both tests can be considered clinically cured. Patients with persistent positive urine bacteria or relapse during follow-up examinations were considered to have failed treatment. Appropriate treatment should be given according to the location and type of urinary sensation.

2. Treatment of chronic nephritis

(1) Special treatment:

① Drug treatment: Patients of all ages with evidence of chronic pyelonephritis need timely diagnosis and careful treatment to prevent recurrence of infection. To cure urinary tract infection, drug sensitivity test is required to select appropriate antibiotics. If the infection occurs again (especially in infants and young children), long-term, continuous antibiotic treatment is required.

②Surgical treatment: surgical operation is used to correct the patient's anatomical defects (especially urinary tract obstruction) and remove stones. Vesicoureteral reflux that affects the efficacy of drugs to varying degrees also requires surgical treatment.

(2) General treatment: To minimize progressive renal damage and functional loss, patients must be closely followed up, urinary tract infections must be strictly controlled, and complications must be detected and treated in a timely manner. Hypertension caused by unilateral atrophic pyelonephritis may be regulated by renin. Such patients may undergo nephrectomy after careful evaluation if indicated.