How Pyelonephritis Medications Work

Pyelonephritis is a bacterial infection of the kidney, typically caused by gram-negative bacteria. The gold standard treatment for pyelonephritis is antibiotics, specifically fluoroquinolones such as ciprofloxacin.

Mechanism of Action

• Fluoroquinolones inhibit bacterial DNA replication and transcription by binding to the enzyme DNA gyrase and topoisomerase IV.
• This leads to an accumulation of double-strand breaks in the bacterial DNA, ultimately resulting in cell death.

Alternatives to Fluoroquinolones

In patients who cannot tolerate fluoroquinolones or have resistant bacteria, alternative treatments include:

• Trimethoprim/Sulfamethoxazole (TMP/SMX), a sulfonamide that inhibits bacterial dihydrofolate reductase.
• Piperacillin/Tazobactam, a carboxypenicillin that inhibits bacterial cell wall synthesis.