What is the first-line treatment for a pregnant patient diagnosed with pyelonephritis?

The first-line treatment for a pregnant patient diagnosed with pyelonephritis is intravenous antibiotics. This is primarily due to the severity of the condition; pyelonephritis during pregnancy can lead to significant complications for both the mother and the fetus if not treated aggressively and promptly. Intravenous antibiotics ensure that the medication is delivered effectively and rapidly into the bloodstream, allowing for higher serum concentrations that can adequately combat the infection.

This route of administration is particularly important in a pregnant patient because pyelonephritis can result in systemic illness, and the intravenous method allows for close monitoring in a healthcare setting. The choice of antibiotics should be guided by local resistance patterns and the safety profile during pregnancy.

While other treatments such as oral antibiotics, fluid resuscitation, and pain management may play supportive roles, they are not sufficient as standalone therapies for a confirmed case of pyelonephritis in pregnancy. Oral antibiotics may be appropriate for milder urinary tract infections but are not adequate for severe cases like pyelonephritis, which often requires immediate and potent intervention. Fluid resuscitation is important if dehydration is present, but it does not directly address the infection itself. Pain management may be necessary for symptomatic relief but will not treat the underlying cause