Diagnosis And Management Of Acute Pyelonephritis In Adults
KALYANAKRISHNAN RAMAKRISHNAN, M.D., and DEWEY C. SCHEID, M.D., M.P.H., University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
Am Fam Physician. 2005 Mar 1 71:933-942.
Acute pyelonephritis is an infection of the upper urinary tract, specifically the renal parenchyma and renal pelvis . Acute pyelonephritis is considered uncomplicated if the infection is caused by a typical pathogen in an immunocompetent patient who has normal urinary tract anatomy and renal function. Misdiagnosis can lead to sepsis, renal abscesses, and chronic pyelonephritis that may cause secondary hypertension and renal failure. Risk factors for complicated acute pyelonephritis are those that increase susceptibility or reduce host response to infections .1,2
What Other Information Should I Know
Keep all appointments with your doctor and laboratory. Your doctor will want to check your response to doxycycline.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking doxycycline.
Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the doxycycline, call your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
How Should This Medicine Be Used
Doxycycline comes as a capsule, delayed-release capsule, tablet, delayed-release tablet, and suspension to take by mouth. Doxycycline is usually taken once or twice a day. Drink a full glass of water with each dose. If your stomach becomes upset when you take doxycycline, you may take it with food or milk. However, taking doxycycline with milk or food may decrease the amount of medication absorbed from your stomach. Talk with your doctor or pharmacist about the best way to take doxycycline. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take doxycycline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the delayed-release tablets and the Acticlate CAP capsules whole do not split, chew, or crush them.
If you cannot swallow certain delayed-release tablets whole, carefully break up the tablet and sprinkle the contents of the tablet on a spoonful of cold or room temperature applesauce. Be careful not to crush or damage any of the pellets while you are breaking up the tablet. Eat the mixture right away and swallow without chewing. If the mixture cannot be eaten right away it should be discarded.
Shake the suspension well before each use to mix the medication evenly.
Continue to take doxycycline even if you feel well. Take all the medication until you are finished, unless your doctor tells you otherwise.
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Is It A Kidney Infection Or Something Else
Your symptoms could also result from another common illness. Some similar conditions you may mistake for a kidney infection include:
- Other UTIs. Other types of UTIs, such as those affecting the urethra and bladder, can also cause symptoms like urgent and painful urination, abdominal pain, and urine thats cloudy, foul-smelling, or bloody.
- Kidney stones.Kidney stones are hard deposits of materials like calcium or uric acid that form in the kidneys. When they become lodged in the kidneys, they can cause pain in the abdomen, side, or back, as well as nausea and vomiting.
- Lower back pain. If low back pain is your primary symptom, you may have a condition thats affecting your lower back. Examples include injuries, degenerative disc disease, and nerve compression.
- Pregnancy. Symptoms like frequent urination, nausea and vomiting, and abdominal cramping can all be early signs of pregnancy.
Its always a good rule of thumb to seek medical attention if you experience any new or concerning symptoms. A healthcare professional can work with you to determine what may be causing them.
Heres an idea of what you can expect when you seek care for a possible kidney infection.
Preventing A Kidney Infection
There are numerous preventative care alternatives and natural home remedy that can be performed to lower kidney infection symptoms and avoid repeating infections. Typically, these methods involve minimizing the possibility of bacteria to go into the urinary tract and turn into an infection. Significant techniques beyond dietary factors to consider and proper hygienic regimens when cleaning consist of:
- Dont hold urine and try to completely empty your bladder without hurrying anything
- Urinate ASAP after sex
- Diaphragms prevent correct and total emptying of the bladder consider changing to various contraception methods
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What Drugs Interact With Amoxicillin And Doxycycline
Amoxicillin is rarely associated with important drug interactions.
- It is recommended that doxycycline not be taken at the same time as aluminum, magnesium, or calcium based antacids, such as Mylanta, Maalox, Tums, or Rolaids because, like food, these medications bind doxycycline in the intestine and prevent its absorption. Similarly, doxycycline should not be taken with minerals or with bismuth subsalicylate .
- Doxycycline may enhance the activity of warfarin and cause excessive “thinning” of the blood leading to exaggerated bleeding, necessitating a reduction in the dose of warfarin. Phenytoin , carbamazepine , and barbiturates may enhance the metabolism of doxycycline thus making it less effective.
- Doxycycline may interfere with the action of penicillins and should not be combined with penicillins. It may also reduce the effect of oral contraceptives. Combining tetracycline and methoxyflurane may reduce kidney function.
How Do I Detox My Kidneys
There is no scientific evidence that kidney cleansing has any effect on kidney health. The best way to detoxify the kidneys is to not toxify them in the first place. Drink plenty of fluids, eat a nutritious diet, avoid processed foods, reduce salt intake, quit smoking, and avoid alcohol, caffeine, and unnecessary medications.
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How To Take It
Always swallow your doxycycline capsule whole and have it with a full glass of water .
You can take this medicine with or without food. However you’re less likely to feel sick if you have it with food.
It’s important to take doxycycline while you’re in an upright position. You can be sitting, standing or walking. This will stop the medicine irritating your food pipe or stomach.
Amoxicillin/potassium Clavulanate Cefdinir Or Cephalexin
How it Works: is another combination drug that belongs to the penicillin class of antibiotics. and belong to a different class of antibiotics thats closely related to penicillins.
All three antibiotics kill bacteria by destroying one of its most important components: the cell wall, which normally keeps bacteria structurally intact.
Amoxicillin/clavulanate: 500 twice a day for 5 to 7 days
Cefdinir: 300 mg twice a day for 5 to 7 days
Cephalexin: 250 mg to 500 mg every 6 hours for 7 days
Notable side effects: Diarrhea, nausea, vomiting, and rash are common side effects of these antibiotics. In rare cases, all three have the potential to cause the dangerous skin reactions, SJS and TEN.
If you have a penicillin allergy, your healthcare provider wont prescribe amoxicillin/clavulanate. They may or may not prescribe cefdinir or cephalexin since there is a small chance that a person with a penicillin allergy may also be allergic to these two.
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Do I Really Need To Take Antibiotics For A Uti
In most cases, it makes sense to start antibiotics if you know you have a bacterial UTI since this is the only way to treat it.
While it is possible for a UTI to go away on its own, this doesnt always happen. Plus, youll still have to deal with uncomfortable UTI symptoms like pain during urination while waiting to see if the UTI will go away. And if it doesnt, the infection can travel up your urinary tract and cause a more serious infection in your kidneys called pyelonephritis. If youre pregnant, have underlying health conditions, or are older than 65 years old, you should not try to treat a UTI without antibiotics.
Driving Or Operating Heavy Machinery
This medicine can cause extreme drowsiness or dizziness in patients. Immediately after taking Doxycycline Tablet or its substitutes, do not drive or operate any heavy machinery.
In addition to the above precautions, make sure that you let the doctor if you are-
- Allergic to drugs such as clarithromycin, erythromycin
- Having issues in the kidneys, muscles, liver or heart
- Having a low level of potassium or magnesium
- Willing to conceive in the future
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Basics Of Doxycycline For Sinus Infection
According to a clinical trial published in the National Library of Medicine, doxycycline was far more effective than ampicillin in curing sinusitis in affected patients. 90% of the patients responded to the drug while only 35% responded to ampicillin. It was inferred that this is effective as it fights against the organisms as well as can penetrate the sinuses which act as a reservoir for the infections.
Doxycycline is an antibiotic that cures a wide variety of infections caused by different bacteria. Apart from sinusitis, it can also cure other bacterial infections including urinary tract infections, respiratory infections, eye infections, gonorrhea, syphilis, etc.
In addition to these infections, medicine is very effective in treating skin blemishes or acne. Moreover, it is believed that taking this drug also reduces the risk of malaria.
Side Effects Of Doxycycline For Sinus Infection
Generally, there are only some minor side effects after taking Doxycycline for sinus infection. Common side effects that can occur after taking doxycycline are-
- Diarrhea that is watery or bloody
- Irritation in the throat
- Difficulty breathing
- Little to almost no urination
- Lower count of white blood cells
- Iron supplements and laxatives
- Oral birth control pills
People who are in the habit of drinking alcohol are more likely to side effects of Doxycycline tablets, especially stomach upset. Moreover, when medicine is taken with milk or food it can reduce the absorption of medicine by the body.
The medicine also enhances the sensitivity of the skin to sunlight. Hence, when stepping out of the house, make sure you are properly covered and wearing sunglasses and sunscreen.
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How To Store Ciprofloxacin
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- If you have been given liquid medicine, it will have been made up by the pharmacy and lasts for 14 days. Remember to check the expiry date on the bottle and do not use it after this date.
What Is A Urinary Tract Infection
The urinary tract is comprised of the kidneys, ureters, bladder, and urethra . A urinary tract infection is an infection caused by pathogenicorganisms in any of the structures that comprise the urinary tract. However, this is the broad definition of urinary tract infections many authors prefer to use more specific terms that localize the urinary tract infection to the major structural segment involved such as urethritis , cystitis , ureterinfection, and pyelonephritis . Other structures that eventually connect to or share close anatomic proximity to the urinary tract are sometimes included in the discussion of UTIs because they may either cause or be caused by UTIs. Technically, they are not UTIs and will be briefly mentioned in this article.
UTIs are common, leading to between seven and 10 million doctor visits per year . Although some infections go unnoticed, UTIs can cause problems that range from dysuria to organ damage and even death. The kidneys are the active organs that produce about 1.5 quarts of urine per day in adults. They help keep electrolytes and fluids in balance, assist in the removal of waste products , and produce a hormone that aids in the formation of red blood cells. If kidneys are injured or destroyed by infection, these vital functions can be damaged or lost.
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Why Should I Take The Full Dose
Antibiotics work well against UTIs. You might start to feel better after being on the medicine for just a few days.
But even so, keep taking your medicine. If you stop your antibiotics too soon, you wonât kill all the bacteria in your urinary tract.
These germs can become resistant to antibiotics. That means the meds will no longer kill these bugs in the future. So if you get another UTI, the medication you take might not treat it. Take the full course of your medicine to make sure all the bacteria are dead.
How Can I Treat A Kidney Infection At Home
Treating kidney infection solely at home or with natural remedies is not a good idea. However, several home remedies can help manage the pain while the infection is treated with antibiotics. These include drinking water, using a heating pad to reduce pain, and taking over-the-counter acetaminophen to manage both pain and fever.
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When To Seek Urgent Care Or Go To The Hospital
Some symptoms point to a more severe infection that needs prompt medical attention.
Go to an urgent care center or hospital if you have any of the symptoms below, which may or may not occur alongside the other UTI symptoms listed above:
- back or side pain
- nausea or vomiting
Kidney infections can cause potentially serious complications. If you feel like something isnt right, dont hesitate to seek care as soon as possible.
Without treatment, a kidney infection can cause serious complications. These can include:
How Effective Is Doxycycline For Uti
A urinary tract infection is often caused by bacteria, and usually affects the bladder, but can spread to other areas of the body in rare cases. Many people choose to treat these infections quickly, as they can cause pain, discomfort, and frequent urination. Frequently, people take doxycycline for UTI relief, because this antibiotic medication is one of the more effective treatments available, as of 2011.
Taking doxycycline to treat a UTI does not immediately kill the bacteria that cause the infection. Instead, this medication prevents the bacteria from growing and dividing, and a person’s immune system cells can then attack the germs. For this reason, the antibiotic must be taken for a time frame of one to two weeks to be effective.
Usually, taking doxycycline for UTI treatment is the most effective when it is taken in doses of 100 milligrams to 200 mg each day. Children often take lower doses, based on their body weight. This dose is equivalent to 1 mg to 2 mg of the medication for every one pound of weight. As mentioned, the drug is normally taken for up to two weeks, although occasionally it must be taken longer to fully fight an infection.
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Main Symptoms Of Kidney Infection
A urinary tract infection usually begins in the bladder and the symptoms and signs of a bladder infection might stay the same after the infection spreads to the kidneys. These indications consist of: cloudy and dark urine that may appear red or pink from blood, unpleasant or burning urination, foul smelling urine, pain in the abdominal area, a heat that remains under 101 degrees Fahrenheit.
When the infection has spread to the kidneys the following additional signs can be expected: a heat that surpasses 101 degrees Fahrenheit, nausea, throwing up, and chills and shaking.
Usually, kidney infection symptoms will feel even worse during urination. A significant change to your typical pattern of urination accompanied with common symptoms and signs of kidney infection are good indications to call your doctor.
Dosage Of Doxycycline For Sinus Infection
The medicine of Doxycycline is available in the following forms-
- Liquid form
- Intravenous solution
Doctors prescribe to take this medicine in the form of pills for people suffering from sinusitis. There are various strengths of Doxycycline for sinus infection- 50, 75, 100, and 150 mg. In order to take the medicine, theres no need to crush or break it. Take one tablet whole while drinking one full glass of water with each dose.
Unless prescribed otherwise by doctors, usually the normal dose of oral form of doxycycline is 200 mg on the first day of the course. Followed by, changing the dosage to two 100 mg doses 12 hours apart. After this, maintaining a dose of 100 mg regularly for 7-10 days.
Although in rare cases, when the infection is severe, doctors can recommend higher doses such as 300 mg daily for 10 days.
Children over 8 years of age can take doxycycline for sinus infection. The dosage of the medicine depends on the childs weight.
Make sure that the course of the medicine is completed. Also, dont stop the medicine abruptly without proper consultation with the doctor.
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