Treatment of purulent pyelonephritis in most cases requires surgical intervention, except those that occur when the contents of the purulent capsule break into the renal pelvis, then the pus is discharged outward with urine through the urinary tract. After the operation, it becomes necessary to resort to antibacterial therapy and to remove intoxication of the body.
To drugs for the treatment of purulent pyelonephritis are antibiotics, which are prescribed after determining the sensitivity of bacteria to it. These can be antibiotics of the aminopenicillin group, which are well tolerated by patients: amoxicillin and penicillin; cephalosporin preparations of a wide spectrum of action: ceftazidime, eurozidim, fortazim, bestum; aminoglycoside - amikacin, gentamicin; fluoroquinolones - levoflonsacin, flobocin, ofloxacin.
Amoxicillin - available in tablets, suspensions, oral solution, dry substance for the preparation of injections. The dose is prescribed individually: children under 2 years 20 mg per kilogram of weight in 3 doses, 2-5 years - 0.125 g, 5-10 years - 0.25 g with the same frequency, over 10 and adults - 0.5 g three times a day. Possible adverse reactions: urticaria, rhinitis, conjunctivitis. It is not recommended for admission to people with hypersensitivity to the drug, be wary of treating pregnant women.
Ceftazidime is an antibacterial preparation, the release form is a solution for intravenous and intramuscular injections. With kidney disorders, the initial dose is 1g, but after surgery it can be half-increased and controlled so that the concentration of the drug in the blood serum does not exceed 40 mg / l. The interval between injections should be 10-12 hours. The drug can cause allergic reactions, dizziness, headache, nausea, diarrhea, colitis. Contraindicated in renal failure, in the first trimester of pregnancy, newborns up to two months, increased sensitivity to penicillins.
Gentamicin - is manufactured in solution for injection. The daily dose for adults is 3-5 mg per kg for 2-4 injections, children after two years are recommended the same dose 2-3 times a day. Treatment with the drug can cause allergies, drowsiness, nausea, changes in indicators characterizing the liver. With caution appoint babies and premature babies.
Ofloxacin - tablets, affects gram-negative bacteria. Admission is carried out at 0.3-0.4 g twice a day, the course of treatment is 7-10 days. Do not prescribe for epilepsy, pregnant and lactating women, children under 15 years. Drug tolerance is good, rarely allergies, nausea, anxiety, headaches.
Surgical treatment of purulent pyelonephritis is almost inevitable. The sequence of the surgeon's actions is as follows: a fibrous capsule is cut in which the kidney is located, thus purulent cavities become visible. Abscesses are cut, cleared and disinfected with antiseptic means, capturing surrounding tissues. After this, drainage is placed in the cavity and retroperitoneal space in order to remove the pus that appears during the healing process. His samples are tested for sensitivity to bactericidal preparations and thus find a suitable antibiotic for treatment. A special tube - nephrostomy is installed to drain urine, after recovery the fistula is healed. Simultaneously with the opening of the abscess, stone can be removed during urolithiasis. Modern techniques make it possible to avoid cavitary surgery, as an alternative - percutaneous puncture with drainage.
The recovery period after the operation with purulent pyelonephritis
The recovery period after purulent pyelonephritis lasts at least two weeks. Immediately after the operation, therapeutic methods of treatment are used to restore the normal functioning of the organ. These include antibacterial, anti-inflammatory medications, drugs that improve blood microcirculation, as well as antioxidant therapy: vitamins A, E, C, b-carotene, lycopene. And resort to infusion therapy - drip infusions (intravenously or subcutaneously) of drugs and biological fluids to restore the water-electrolyte and acid-base balance in the body.