Comparative Analysis of Clinical Parameters in Acute Pyelonephritis

The Clinical Guidelines for Acute Uncomplicated Cystitis and Acute Uncomplicated Pyelonephritis

“…The major causative organism of acute pyelonephritis is E. coli, and from 2000 to 2005, 79% of the 2,910 multicenter studies in Korea reported E. coli-induced pyelonephritis [24]. The most common causative organism for acute pyelonephritis was determined to be E. coli in other domestic studies.…”

“…The detection of bacteria in the urine culture under clinical diagnosis of acute pyelonephritis is 46.3-78.8% [24,26]. If causative organisms are not detected, it can be considered as one of two things: the infection cannot be cultured after inoculation on blood agar medium and MacConkey agar medium, or the antibiotics has been taken from primary medical institutions or pharmacies.…”

“…The most common causative organism for acute pyelonephritis was determined to be E. coli in other domestic studies. K. pneumoniae, Proteus mirabilis, Enterococcus strain, and S. saprophyticus have also been identified [7,17,[24][25][26]. These causative organisms differ in C, white blood cells below 4,000 or above 12,000, heart rate of less than 90/min, respiratory rate of more than 20/min, PaCO 2 below 32 mmHg, systolic blood pressure below 90 mmHg (Grade C).…”

“…Fluoroquinolone can be used as a primary treatment in areas with its resistance rate of around 10% (LE: 1b, GR: A) [35]. In Korea, the resistance rate of fluoroquinolone (6.9-12.9%) and third-generation cephalosporin (ex, cefotaxim: 0.8-10.2%) antibiotics is reported to be around 10% [24,26]. If the dose of fluoroquinolone is increased, the treatment period may be shortened to 5 days (LE: 1b, GR: B) [36,37].…”

“…The resistance rates to E. coli are high with ampicillin (62.3%), TMP-SMX (36.7-37.2%), and first-generation cephalosporin (33.9-58.3%). It is not appropriate as a primary antibiotic for patients with acute uncomplicated pyelonephritis [24,26]. Fluoroquinolone can be used as a primary treatment in areas with its resistance rate of around 10% (LE: 1b, GR: A) [35].…”