A kidney abscess is the phenomenon of pus accumulation around the kidney due to infection of the surrounding soft tissues or infection of the peripheral renal tissue. This is a serious condition, so outpatient treatment is very rarely indicated.
Kidney abscesses often present symptoms such as fever accompanied by chills, uncontrollable shaking, excessive sweating, abdominal pain, painful urination, blood in urine, low blood pressure, pale skin, and rapid heartbeat.
After diagnosis, based on the size and condition of each patient, the doctor will prescribe an appropriate treatment method.
1. Medications for Treating Kidney Abscesses
1.1. Antibiotics
Antibiotics are used according to the antibiotic susceptibility test based on the results of blood, urine, or fluid cultures from the infection site, which is the best approach. The duration and dosage of antibiotics depend on the severity of the disease.
In cases where the patient has impaired kidney function, it is necessary to choose antibiotics that are not nephrotoxic, do not reduce the glomerular filtration rate, and adjust the dosage according to the glomerular filtration rate.
Currently, there are many different groups of antibiotics available to treat infectious conditions related to urinary tract diseases. However, the use of antibiotics should be prescribed by qualified physicians based on the clinical manifestations and test results of the patient. Monotherapy (one group) or combination therapy (two or more groups) may be used.
Some groups of antibiotics that can be used in cases of mild bacterial infections:
- Trimethoprim (not to be used in the first 3 months of pregnancy).
- Trimethoprim/sulfamethoxazole (not to be used in the first 3 months and the last 3 months of pregnancy).
- Cephalosporins…
Cases of moderate to severe infections requiring inpatient treatment may use some medications such as fluoroquinolones, ceftriaxone, piperacillin/tazobactam, imipenem/cilastatin, meropenem…
Patients need to adhere to the antibiotic regimen prescribed by the doctor. In practice, many patients arbitrarily stop taking medication after 2-3 days of treatment when they feel symptoms have improved. This is one of the common mistakes that reduce treatment effectiveness. In the long run, this habit increases the risk of antibiotic resistance, making treatment more difficult.
Using antibiotics can cause typical side effects such as loose stools (diarrhea), as antibiotics disrupt the normal functioning of healthy bacteria in the intestines. This is why a doctor may prescribe probiotics after antibiotic treatment.
1.2. Antipyretics and analgesics
Patients with kidney abscesses may use non-aspirin antipyretics containing acetaminophen to treat symptoms of fever or discomfort.
If used in the correct prescribed dosage, paracetamol is considered a relatively safe medication. However, it can cause liver toxicity when taken in high doses or for extended periods. Additionally, it may cause allergic reactions in individuals with hypersensitivity, including symptoms such as difficulty breathing, hives, swelling of the lips, tongue, face, or throat. It is contraindicated in cases of hypersensitivity to the drug’s components, and in patients with severe liver or kidney impairment.
1.3. Medications for treating comorbid conditions
Proper management of comorbid conditions helps improve the infection status, enhance overall health, and reduce the risk of worsening and recurrence of the disease.
– ACE inhibitors are indicated in cases where patients have both hypertension and kidney abscess. These medications work by inhibiting the activity of the ACE enzyme, reducing the production of angiotensin II. As a result, blood vessels dilate, vascular resistance decreases, and blood pressure drops. The reduced vascular resistance helps the heart pump blood more easily, improving the function of a weakened heart. Decreasing the production of angiotensin II will lower glomerular filtration pressure, thus providing renal protection.
However, these medications may have side effects such as a dry cough, hyperkalemia, sudden hypotension, and angioedema. It is important to take the medication regularly, ideally at the same time each day. Avoid taking ACE inhibitors simultaneously with NSAIDs like ibuprofen, as this may reduce the effectiveness of the ACE inhibitors
– Metformin and insulin are prescribed for patients with diabetes who have renal abscesses. The medication helps control blood sugar levels, thereby preventing complications of diabetes affecting the kidneys.
Insulin also has side effects, but they are less common. Patients may experience symptoms such as hypoglycemia, rash, itching at the injection site, etc. Most of these side effects can be managed and do not lead to severe consequences.
Metformin is a medication that increases insulin sensitivity. The advantage of metformin is that it does not cause hypoglycemia when used alone and does not lead to weight gain. The drug also reduces the absorption of bad cholesterol and triglycerides, preventing cardiovascular issues. However, it should not be used in patients with renal failure. In some cases, patients may experience digestive issues such as diarrhea, indigestion, and loss of appetite.
1.4. Subcutaneous drainage method
In some cases of abscess formation, after a period of systemic antibiotic treatment and improving the patient’s condition, the subcutaneous drainage method can be combined to help release the infection site, clean the area, and potentially deliver antibiotics to the site of inflammation.
However, this method requires to be performed at a medical facility by trained specialists, and the patient must meet the necessary conditions to undergo the intervention. On the other hand, the procedure also carries the risk of spreading the infection to other areas if the intervention method is not chosen correctly.
