Acute pyelonephritis: clinical characteristics and the role of the surgical treatment.
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.
Lee
Dong-Gi
DG
Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea.
Jeon
Seung Hyun
SH
Lee
Choong-Hyun
CH
Lee
Sun-Ju
SJ
Kim
Jin Il
JI
Chang
Sung-Goo
SG
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000667:Ampicillin / Q000627:therapeutic use; D004351:Drug Resistance; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination