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Patient leaflets from the BMJ Group Kidney infection Having a kidney infection can make you feel very ill. But if you get the right treatment, you should make a quick recovery. What happens in a kidney infection? Your kidneys make urine from your body’s waste products. Most kidney infections start when bacteria get into your urethra, the tube you use to urinate. The bacteria may spread to infect one or both kidneys. Doctors call a kidney infection pyelonephritis. Most people can be treated at home. But you might need treatment in hospital if you have problems with the structure of your bladder, ureters, or kidneys. You might also need hospital treatment if you are very unwell, if you have kidney stones, if you are pregnant or if you are older than 60. Anyone can get a kidney infection, but certain things make it more likely. These are called risk factors. For women, risk factors for kidney infections are the same as for bladder infections (cystitis). They include: • Having sex often • Using a spermicide for contraception • Having had cystitis in the last year • Having diabetes. What are the symptoms? Most people with kidney infections feel very ill. The symptoms usually come on over a few hours. You may have a high temperature, shivering, pain in your side, back ache, nausea, vomiting, or diarrhoea. You may feel the need to pass urine very often. This may be painful. Your urine may look cloudy or be a different colour. It may smell strongly. If you're older you may have different symptoms. These could be a high temperature on its own, pain in your side or back, confusion and sluggishness, or loss of appetite. But some people with a kidney infection get very few symptoms or even none at all. The symptoms of a kidney infection can be similar to those of other illnesses, including pelvic inflammatory disease, appendicitis, and kidney stones. You’ll need a urine test for signs of infection. You might also need a blood test. Some people need further tests, such as an X-ray, ultrasound, or CT scan. What treatments work? The usual treatment for a kidney infection is antibiotics. There are lots of different types. Most people take antibiotic tablets at home, but some people need to have antibiotics as a drip in hospital. © BMJ Publishing Group Limited 2009. All rights reserved. page 1 of 3 Kidney infection Most of the research looks at kidney infections in women who aren't pregnant. But the same treatments are used for men with kidney infections. Medicines If you're well enough not to need treatment in hospital, you'll be given antibiotic tablets to take at home. You'll probably take tablets for one or two weeks, depending on how severe your infection is. Some doctors recommend taking antibiotics for at least 10 days, but there’s no research to show for sure what works best. You should start to feel better within two to three days and be completely better in two weeks. You should always finish your tablets, even if you're feeling better before then. Antibiotics used for people with kidney infections include amoxicillin (brand name Amoxil), ampicillin (Penbritin), ciprofloxacin (Ciproxin), co-amoxiclav (Augmentin), co-trimoxazole (Septrin), and cefaclor (Distaclor). Research shows that different types of antibiotics work about as well as each other. But some antibiotics no longer work against particular types of bacteria, because the bacteria have changed to become resistant to them. This varies from place to place. Antibiotic tablets can cause side effects, including stomach upsets and diarrhoea. Things you can do for yourself Kidney infections can be painful. You may want to take painkillers to help reduce the pain and fever. If you're in a lot of pain, tell your doctor. He or she can prescribe a stronger painkiller. Most doctors recommend paracetamol. Be careful not to take too high a dose. Taking too much can cause serious liver damage. Aspirin and ibuprofen (Nurofen) are also common painkillers. But they can have side effects, so you need to be careful not to take too much. You can also drink plenty of fluids. Make sure you let your doctor know if you don't feel a lot better after four days of taking antibiotics. Other treatments If you need to be treated in hospital, you may be given antibiotics through a drip (IV) in your arm. They work quickly, because they go straight into your bloodstream. You may have antibiotics through a drip for three days, then switch to tablets once the infection is getting better. There hasn't been any research to say whether antibiotic drips work better than tablets. Research shows that about a third of women having antibiotics by a drip get side effects, including a rash, diarrhoea, nausea, and inflammation of their vagina. Some people have an antibiotic drip and antibiotic tablets together. But there hasn't been enough research to say whether having antibiotics as both tablets and a drip works better than having tablets on their own. © BMJ Publishing Group Limited 2009. All rights reserved. page 2 of 3 Kidney infection What will happen to me? What will happen to you depends on several things.These include how bad your infection is, how old you are, whether you have other health problems and whether you get the right medicine. Sometimes antibiotic treatment doesn't work. This may happen if the bacteria causing the infection are resistant to the antibiotic you've been given. You'll need to try a different antibiotic. Most people get better completely with treatment. But some get a build-up of pus in their kidney, called an abscess. You may need an operation to remove the pus. Two serious but rare complications are sepsis and kidney failure. Sepsis is caused by bacteria getting into your bloodstream. Kidney failure is when your kidneys stop working. If either of these things happen, you’ll need intensive care in hospital. Some people get repeated kidney infections, which may damage their kidney. These infections usually happen less often with time, but your doctor may recommend that you take a small dose of an antibiotic every day to prevent them. This information is aimed at a UK patient audience. This information however does not replace medical advice. If you have a medical problem please see your doctor. Please see our full Conditions of Use for this content http://besttreatments.bmj.com/btuk/about/12.html. © BMJ Publishing Group Limited 2009. All rights reserved. Last published: Mar 03, 2010 page 3 of 3