What is the recommended outpatient treatment for pyelonephritis?

The recommended outpatient treatment for pyelonephritis is ciprofloxacin. This fluoroquinolone antibiotic is particularly effective against the common pathogens causing urinary tract infections, including Escherichia coli, which is often implicated in pyelonephritis. Ciprofloxacin has excellent oral bioavailability and good renal penetration, making it a suitable choice for treating kidney infections in an outpatient setting.

In addition to its efficacy, the convenience of an oral formulation allows for greater patient compliance compared to intravenous antibiotics, which may be necessary in more severe or complicated cases of pyelonephritis.

While other antibiotics could theoretically be used in certain situations, they are generally not the first choice. Amoxicillin, while effective against some urinary pathogens, has limited efficacy against E. coli, especially in regions with high resistance rates. Cephalexin, a first-generation cephalosporin, also has limited coverage against resistant organisms. Gentamicin, an aminoglycoside, is primarily used in a hospital setting due to its need for monitoring renal function and potential side effects, as it is not typically administered as initial outpatient therapy for pyelonephritis.

Therefore, ciprofloxacin stands out as the preferred choice for outpatient management of uncomplicated