management of any urinary tract infection - more prolonged treatment is required than acute cystitis (1)
antibiotic prophylaxis is indicated for patients with recurrent urinary tract infections (2)
investigation and treatment of underlying cause e.g. obstruction
nephrectomy is indicated in unilateral chronic pyelonephritis when the diseased kidney contributes less than 20% of total renal function (3)
Reference
Managing common infections: guidance for primary care. Public Health England, August 2020 - last updated June 2021
Garin EH et al. Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study. Pediatrics. 2006 Mar;117(3):626-32.
Soo Park B et al. Outcome of nephrectomy and kidney-preserving procedures for the treatment of emphysematous pyelonephritis. Scand J Urol Nephrol. 2006;40(4):332-8.
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