Urinary Tract Infections

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Pyelonephritis in Severe Sepsis or Septic Shock

First line treatment

  • Piperacillin/Tazobactam 3.375g IV every 6 hours plus Gentamicin 3mg/kg IV every 24 hours plus Vancomycin 15mg/kg IV every 12 hours*

Penicillin alternative

  • Aztreonam 1g IV every 8 hours plus Gentamicin 3mg/kg IV every 24 hours plus Vancomycin 15mg/kg every 12 hours* 

Duration

  • 10-14 days

Notes

De-escalate from broad spectrum antibiotics when pathogen sensitivities become available.

*For any toxic patient, consider a Vancomycin loading dose of 25 mg/kg followed by 15 mg/kg every 12 hours. Every Vancomycin order requires pharmacokinetic consult.

 

Disclaimer: The contents of this application are for the exclusive and specific use of University of Mississippi Medical Center faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only. The contents of this application are for the exclusive and specific use of UMMC faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only.