Is oral administration of antibiotics more effective than other regimens for the treatment of acute pyelonephritis (kidney infection)?

Updated: Jul 01, 2021
  • Author: Tibor Fulop, MD, PhD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Growing data suggest that oral antibiotic therapy, parenteral antibiotic therapy, and initial parenteral antibiotic therapy followed by oral antibiotic therapy are equally effective regimens, although most of the studies have been small. [27, 28] Some clinicians believe that initiating therapy with an intravenous or intramuscular dose of medication reduces the risk of therapeutic failure; other clinicians believe that a completely oral course is sufficient. Data exist to support both assertions.

One conventional regimen comprises levofloxacin, 500 mg/day, given intravenously and then orally for 7-14 days. A short-course regimen of intravenous levofloxacin at 750 mg/day for 5 days proved non-inferior to that conventional regimen in a prospective, open-label, randomized, controlled clinical trial in 317 Chinese patients with complicated urinary tract infections and acute pyelonephritis. [29]


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