Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared outside of the session

CME Credit Offered

Abstract Award

Recording available 2/16-5/2

AIUM Credit

Foundation Awardee

Poster Icons

Abstract Award

Foundation Awardee

Poster Session 4

Category: Obstetric Quality and Safety

Poster Session 4

(1162) Treatment outcomes in pyelonephritis during pregnancy following practice change from ampicillin and gentamicin to ceftriaxone

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Lisa R. Thiele, MD, MPH (she/her/hers)

Resident
UT Southwestern
Dallas, Texas, United States

Coauthor(s)

Sana Jaleel, BA

University of Texas Southwestern Medical Center
Dallas, Texas, United States
DM

Donald D. McIntire, PhD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
Emily H. Adhikari, MD (she/her/hers)

Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Elaine L. Duryea, MD

Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Catherine Y. Spong, MD

Professor and Chair
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Objective:
To evaluate the impact of a practice change from a combined regimen of ampicillin and gentamicin (amp/gent) to single agent ceftriaxone for pyelonephritis in pregnancy.

Study Design:
This retrospective cohort study examined outcomes for pregnant patients treated before and after a change in treatment protocol for pyelonephritis at our institution from amp/gent to ceftriaxone as first-line therapy. Treatment is standardized using electronic order sets and written protocols. Data including demographics, laboratory data, medical comorbidities, and characteristics of pyelonephritis treatment and admissions were examined.

Results:
Of 153 treated for antepartum pyelonephritis, 93 were treated during the Amp/Gent protocol (1/1/2022-12/31/2022) and 60 during the Ceftriaxone protocol (12/5/2024-5/5/2025). Patients in the ceftriaxone cohort had more pronounced leukocytosis (15.1 ± 4.0 vs.13.7 ± 4.3, p=0.04) and higher maximum heart rate (128.6 ± 17.4 vs. 120.2 ± 17.9, p=0.005), Table. There was no significant difference in the duration of IV antibiotic therapy or length of stay between cohorts. There was a significant decrease in the number of doses given (8.9 vs 4.5, p = < 0.001) in the ceftriaxone cohort. E. Coli was the predominant pathogen, followed by Klebsiella and ESBL. Pathogenic organisms in both cohorts were more susceptible to Ceftriaxone (88-100%) than Ampicillin (43%-50%) or Gentamicin (50-100%), Figure.

Conclusion:
Transitioning from dual (amp/gent) to single agent (ceftriaxone) therapy as primary regimen for treatment of pyelonephritis in pregnancy was associated with fewer doses of antibiotics without effect on length of stay or duration of antibiotic therapy. The difference in severity of illness, as measured by leukocytosis and max temperature, limits interpretation of the effect of the p</span>rotocol change.