Not Found

Find information on medical topics, symptoms, drugs, procedures, news and more, written for the health care professional.

Postpartum Pyelonephritis

By Julie S. Moldenhauer, MD, Associate Professor of Clinical Obstetrics and Gynecology in Surgery, The Garbose Family Special Delivery Unit; Attending Physician, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia; The University of Pennsylvania Perelman School of Medicine

Click here for
Patient Education

Pyelonephritis is bacterial infection of the renal parenchyma.

Pyelonephritis may occur postpartum if bacteria ascend from the bladder. The infection may begin as asymptomatic bacteriuria during pregnancy and is sometimes associated with bladder catheterization to relieve urinary distention during or after labor. The causative organism is usually a type of coliform bacteria (eg, Escherichia coli).

Symptoms include fever, flank pain, general malaise, and, occasionally, painful urination.


  • Urinalysis and urine culture

Diagnosis is based on urinalysis, urine culture, and clinical findings (see Bacterial Urinary Tract Infections (UTIs) : Diagnosis).


  • Ceftriaxone alone or ampicillin plus gentamicin

Initial treatment is ceftriaxone 1 to 2 g IV q 12 to 24 h alone or ampicillin 1 g IV q 6 h plus gentamicin 1.5 mg/kg IV q 8 h until women are afebrile for 48 h. Sensitivities with culture should be checked. Treatment is adjusted accordingly and continued for a total of 7 to 14 days; oral antibiotics are used after the initial IV antibiotics. Women should be encouraged to consume large amounts of liquids.

A urine culture should be repeated 6 to 8 wk after delivery to verify cure. If episodes of pyelonephritis recur, imaging should be considered to look for calculi or congenital malformations. Imaging during pregnancy is usually with ultrasonography; imaging after pregnancy is usually with contrast CT.

Drugs Mentioned In This Article

  • Drug Name
    Select Trade
  • No US brand name