Actualización del manejo farmacológico en complicaciones obstétricas en gestantes por pielonefritis aguda

Abstract

Acute pyelonephritis during gestation is an obstetric complication that can have significant effects on both the mother and the fetus. Objective: To describe an update on pharmacological management in obstetric complications in pregnant women with acute pyelonephritis. Methodology: A narrative literature review was conducted, encompassing relevant medical and scientific sources through comprehensive searches in biomedical databases such as PubMed, Scopus, and Cochrane Library. Results: Studies demonstrate variability in bacteriuria sensitivity to different antibiotics. It is emphasized that amoxicillin-clavulanate, nitrofurantoin, and gentamicin are effective in treating the infection. Other antibiotics such as ciprofloxacin, cefuroxime, cefotaxime, ampicillin, vancomycin, and ceftazidime have also shown sensitivity in some studies. Cephalexin and ciprofloxacin exhibited high sensitivity percentages. Various therapeutic strategies and antibiotic therapies were employed to treat pyelonephritis during gestation. A conservative therapy including protected penicillins and third or fourth-generation cephalosporins is also utilized. The addition of Wobenzym to the therapy is highlighted for its potential to improve blood flow in the renal artery. In the context of pyelonephritis treatment during labor, common antibiotic therapies observed include nitrofurantoin, ampicillin, and cephalexin. Moreover, the use of single-dose treatments, especially with fosfomycin, has been considered. Conclusions: The results and recommendations derived from this narrative literature review have the potential to enhance maternal and neonatal outcomes by effectively addressing these complications.