J Korean Med Sci.  2009 Apr;24(2):296-301. 10.3346/jkms.2009.24.2.296.

Acute Pyelonephritis: Clinical Characteristics and the Role of the Surgical Treatment

• Lee DG
• Jeon SH
• Lee CH
• Lee SJ
• Kim JI
• Chang SG

• KMID: 1779133
• DOI: http://doi.org/10.3346/jkms.2009.24.2.296

Abstract

The epidemiology of acute pyelonephritis (APN) has changed with time. Therefore we investigated the current clinical characteristics of APN and the significance of proper surgical management for treatment of 1,026 APN patients in South Korea for the past 5 yr. The male-to-female ratio was about 1:8. The peak ages of female patients were 20s (21.3%) and over 60s (23.7%), while that of male was over 60s (38.1%). The occurrence of sepsis was 10.1%. Complicated APN patients were 35.4%. Ninety-four patients (9.2%) needed urological procedures. The duration of the flank pain and of the costovertebral angle tenderness in complicated APN patients was statistically significantly longer than that with simple APN patients (4.3 vs. 3.4 days, 4.4 vs. 4.0 days). If flank pain and costovertebral angle tenderness sustain over 4 days, proper radiologic studies should be performed immediately with the consideration of surgical procedure. Also the resistance to antibiotics was increasing. As the sensitivities to ampicillin (27.2%) and trimethoprim/sulfamethoxazole (44.7%) of Escherichia coli and Klebsiella pneumoniae were very low, it is necessary to take the careful choice of antibiotics into consideration.

Keyword

Urinary Tract Infections; Pyelonephritis; Urologic Surgical Procedures

MeSH Terms

Acute Disease
Adult
Aged
Ampicillin/therapeutic use
Drug Resistance
Escherichia coli Infections/drug therapy/etiology
Female
Humans
Klebsiella Infections/drug therapy/etiology
Male
Microbial Sensitivity Tests
Middle Aged
Pyelonephritis/complications/*diagnosis/*surgery
Retrospective Studies
Sepsis/diagnosis/etiology
Trimethoprim-Sulfamethoxazole Combination/therapeutic use

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