Antibiotics For Kidney Infection

  • Soumya Iyer International Baccalaureate, Natural Sciences, Global Schools Foundation
  • Hai Long Le MPharm, University of Birmingham
  • Zayan Siddiqui BSc in Chemistry with Biomedicine, KCL, MSc in Drug Discovery and Pharma Management, UCL

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Introduction

Definition of kidney infection

Kidney Infections are caused by pathogens (bacteria or viruses). It is generally characterised by the inflammation of either or both kidneys and requires instant medical attention.

Importance of timely treatment

Kidneys are necessary for filtering out waste products produced by various metabolic processes. When infected, they are unable to perform this function and without timely treatment, there can be a chance of permanent kidney damage. This comes with prolonged hospital visits and increased chances of recurrent infections. As with all infections, it is important to tend to them at the earliest to reduce any amounts of discomfort and pain. Antibiotics are the first course of treatment because kidney infections are caused by bacteria. The type depends on the bacteria causing the infection and how its machinery works.

Understanding kidney infections

Causes and risk factors

Kidney Infections usually happen due to a urinary tract infection (UTI), as the bacteria move through the urethra to the kidneys. Another cause of Kidney infections originates from kidney stones that are favourable for bacterial growth. The individuals that are at high risk for this condition include pregnant persons assigned female at birth (AFAB), diabetes, urinary tract abnormalities and more. Most of these lead to UTIs that develop into kidney infections, therefore it’s important to get diagnosed early to prevent the spreading of bacteria.

Symptoms and diagnosis

Common symptoms when you have a kidney infection include the following:

  • Nausea
  • Frequent urination or feeling of urination
  • Fever and chills
  • Sharp pain in the lower back

Doctors can diagnose a kidney infection by checking your medical history as well as a urine analysis. They will also check your temperature and blood pressure to understand the level of infection. Additionally, for men, doctors may conduct a rectal exam to check for an enlarged prostate gland that could impede urine flow.

Role of antibiotics

How do antibiotics work?

Antibiotics are prescription-only medications that help resolve infections caused by bacteria. Their main treatment route involves cell wall synthesis inhibition and metabolic process interferences. Different classes of antibiotics target different biochemical processes within the cell depending on the type of bacterial infection.

The bacterial cell wall is made up of peptidoglycans which is a polysaccharide. The antibiotics prevent the bacterial cell from synthesising the cell wall which leads to the breakdown of cells. An example of this antibiotic is beta-lactam antibiotics. The second class of antibiotics attacks the process of protein synthesis by targeting the ribosomal subunits (30S or 50S). The subunits are different from the ones in the human body hence do not affect normal protein synthesis within the body. 

Specific antibiotics for kidney infections

Commonly prescribed antibiotics

Some of the commonly prescribed antibiotics for kidney infections include cephalexin, co-amoxiclav and ciprofloxacin. They can be prescribed prior to a urine test unless the condition is overly complicated. The course for this form of treatment lasts around 1 or 2 weeks.

Administration and dosage

Oral antibiotics

Oral antibiotics are cheaper than intravenous antibiotics and therefore, are the majority of prescriptions for bacterial infections. Another benefit of this route includes decreased chances of thrombophlebitis which is the swelling of veins generally due to a blood clot at the site of injection. 

Intravenous antibiotics

This procedure involves injecting antibiotics directly into the bloodstream in hospitals. This is recommended especially for those with problems swallowing oral drugs i.e. vomiting, which is a common symptom; and for those who are immunocompromised as they cannot fight off infections like a normal individual. Intravenous form of administration allows for the optimal concentration to be delivered into the body, hence, eliminating the need for a longer course of treatment. Subsequently, the latest research suggests that after 48-72 hours of intravenous antibiotics, the patient can use oral antibiotics to rid the infection without any discernible side effects. This is also a cost-effective and convenient method of treatment.

Duration of treatment

The duration of an antibiotic treatment is wholly dependent on the type and severity of an infection. Infections like strep throat and respiratory infection can range from 10-14 days for an entire course. However, this can be lengthened if needed as long as the course is prescribed by a medical professional to prevent any chances of reinfection.

Precautions and side effects

Allergies and sensitivities

Allergies with certain antibiotics can lead to increased sensitivity to other antibiotics, so doctors have to check full medical history to ensure the prescribed course of treatment will not lead to any unwanted reactions. An allergy test is generally done when this information is not known by the patient or there is a limited number of antibiotics available.

A painkiller might be included in the set of prescribed drugs to help reduce the patient’s temperature whilst managing their discomfort and pain.

Potential side effects

Even though antibiotics are prescribed regularly for bacterial infections, everybody reacts differently, therefore, it is necessary to regulate its use. Some common side effects include dizziness, nausea and rashes. In some severe cases, there could be the development of life-threatening allergic reactions, severe colon damage or even death.

Monitoring for adverse reactions

Since each patient can react differently to antibiotics, doctors need to monitor the reactions towards the prescribed medication. Antibiotics have a great effect on liver enzymes and kidney function therefore these organs have to be closely monitored to prevent any further complications.

Importance of completing the full course

Preventing antibiotic resistance

Antibiotics are prescribed for the length it would take for the bacterial infection to clear out of your system, hence, it is important to track the full course. Even if you feel better in a few days, it is necessary to finish the whole course to prevent the rise of antibiotic-resistant pathogens. This causes further damage as they cannot be treated with regular antibiotics and require special care. There is a set duration for common bacterial infections set by the World Health Organisation (WHO) to prevent any courses that are longer or shorter as they both can cause harm to the body.

Consultation and follow-up

Seeking medical advice

It is important to seek help from a medical professional in the case of a bacterial infection as the course of treatment has to be prescription antibiotics. Along with this, it is necessary to have follow-up appointments to ensure the antibiotics have cleared up the infection completely and there are no chances of reinfections.

If the infection is recurring, it is advised to go to a nephrologist to get more specific help with dealing with the condition.

Prevention of kidney infections

Hygiene practices

Drinking plenty of water is essential to maintaining a healthy kidney. This helps remove waste products regularly and reduces the chances of bacterial infection. In addition to this, regular urination and urinating after sex are also integral to having clean genitals. This prevents bacteria from surviving within the body as well. It is also important to wash and clean your body regularly to prevent bacterial growth that could develop into various infections, especially for those who are prone to health problems. Apart from these personal practices, one should also visit a doctor when they have any symptoms of UTI or kidney infection to prevent it from developing into a lethal condition.

Summary

  • A common cause of kidney infection is untreated urinary tract infection
  • Symptoms of kidney infection include excessive urination, nausea, fever, back pain and loss of appetite
  • Antibiotics are the first course of treatment for a kidney infection provided the patient has no allergies or sensitive reaction to the prescribed drug
  • Antibiotics work by interfering in bacterial metabolic processes like protein and cell wall synthesis
  • A full course of antibiotics has to be followed to prevent any side effects or antibacterial resistance, therefore, it is important to only have them when and as prescribed
  • The duration of treatment depends on the extent of the infection and the bacteria causing it but generally ranges from 5-12 days
  • Antibiotics can be administered intravenous or orally depending on the severity of the condition
  • Drinking lots of water and maintaining personal hygiene are integral to maintaining healthy kidneys
  • Most people prone to kidney infections are pregnant, diabetic or old but that does not mean they are the only victims of the disease

References

  1. Kapoor G, Saigal S, Elongavan A. Action and resistance mechanisms of antibiotics: A guide for clinicians. Journal of Anaesthesiology Clinical Pharmacology. 2017;33(3):300. doi:10.4103/joacp.joacp_349_15 
  2. [Internet]. Centre for Disease Control; [cited 2024 Jan 18]. Available from: https://www.cdc.gov/antibiotic-use/community/pdfs/aaw/AU_Arent_Always_The_Answer_fs_508.pdf 
  3. Kidney infection - symptoms, treatment and prevention [Internet]. 2023 [cited 2024 Jan 19]. Available from: https://www.kidneyfund.org/all-about-kidneys/other-kidney-problems/kidney-infection 
  4. Kidney (renal) infection - pyelonephritis [Internet]. [cited 2024 Jan 17]. Available from: https://www.urologyhealth.org/urology-a-z/k/kidney-(renal)-infection-pyelonephritis 
  5. McCarthy K, Avent M. Oral or intravenous antibiotics? Australian Prescriber. 2020;43(2):45–8. doi:10.18773/austprescr.2020.008 
  6. Kidney infection symptoms and treatments [Internet]. 2023 [cited 2024 Jan 19]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/kidney-infection/ 
  7. Tidy DC. Kidney infection: Causes, symptoms, and treatment [Internet]. 2023 [cited 2024 Jan 17]. Available from: https://patient.info/kidney-urinary-tract/kidney-infection-pyelonephritis 

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Soumya Iyer

International Baccalaureate, Natural Sciences, Global Schools Foundation

Soumya is currently an undergraduate student pursuing BSc Biological and Biomedical Sciences (joint degree with National University of Singapore) at the University of Dundee, Scotland. As someone very passionate about scientific communication, she’s undertaken this internship following her previous experience in writing scientific reports.

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