(1) special treatment: infection of severe or complicated by kidney disease, urinary tract deformity patients hospitalized with acute pyelonephritis. Immediately collected blood and urine samples were cultured to determine pathogen after antibiotic sensitivity test. Before the result of drug sensitivity test is not clear, antibiotics can be chosen by experience. Although each doctor's choice of antibiotics is different, but generally available one of the aminoglycoside plus ampicillin intravenous administration. If the pathogen of drug sensitivity, good clinical effect, continued for 1 weeks, and then switch to the appropriate antibiotics for 2 weeks, the factors of complications, such as urinary tract calculi obstruction, infection, should be found and treated as early as possible, so as to avoid the occurrence of complications.
(2) general treatment: symptoms should disappear before bed rest, pain, fever and nausea and other drugs can be symptomatic treatment. Encourage more water or intravenous fluids to maintain adequate body fluids and urine output.
(3) the treatment of poor efficacy: after treatment for 48 to 72 hours, the condition is still not improved, it may be inappropriate choice of antibiotics or a variety of adverse factors (such as urinary tract obstruction). This should be excretory urography examination, retrograde urography with contraindications, unless the timely and effective treatment, or acute pyelonephritis complicated by urinary tract obstruction can cause bacteremia and irreversible kidney damage.
(4) follow up: clinical improvement was not equal to the cure of infection, and in the 1/3 of patients, there was still a latent disease after the improvement of symptoms. Therefore, multiple urine cultures should be repeated during or after treatment.
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