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Comparison of Second- and Third-Generation Cephalosporin as Initial Therapy for Women with Community-Onset Uncomplicated Acute Pyelonephritis.

Chang UI, Kim HW, Wie SH - Yonsei Med. J. (2015)

Bottom Line: The rates of defervescence showed no significant differences in the two groups at 48, 72, 96, and 120 hours.The clinical cure rates observed at the follow-up visit 4 to 14 days after the completion of antimicrobial therapy were not statistically different between the cefuroxime and cefotaxime groups [94.9% (129 of 136) versus 98.0% (100 of 102), respectively; p=0.307], and the microbiological cure rates were also not significantly different [88.3% (91 of 103) versus 95.0% (76 of 80), respectively; p=0.186].Cefuroxime, a second-generation cephalosporin, is an appropriate antibiotic option for the initial treatment of uncomplicated APN and its efficacy does not differ from cefotaxime, a third-generation cephalosporin, in the initial parenteral therapy for community-onset APN.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Purpose: This study examined the clinical effectiveness of parenteral cefuroxime and cefotaxime as empirical antibiotics for treating hospitalized women with uncomplicated acute pyelonephritis (APN).

Materials and methods: This study was based on the clinical and microbiologic data of 255 hospitalized women with APN. Of these 255 women, 144 patients received cefuroxime and 111 received cefotaxime.

Results: There were no marked differences in the demographic features, clinical characteristics, and treatment duration between the populations of the cefuroxime and cefotaxime groups. The rates of defervescence showed no significant differences in the two groups at 48, 72, 96, and 120 hours. The clinical cure rates observed at the follow-up visit 4 to 14 days after the completion of antimicrobial therapy were not statistically different between the cefuroxime and cefotaxime groups [94.9% (129 of 136) versus 98.0% (100 of 102), respectively; p=0.307], and the microbiological cure rates were also not significantly different [88.3% (91 of 103) versus 95.0% (76 of 80), respectively; p=0.186]. The median hospitalization periods in the cefuroxime and cefotaxime groups were 7 (6-8) and 7 (6-8) days (p=0.157), respectively. Microbiological success rates after 72-96 hours of initial antimicrobial therapy were also not statistically different in the cefuroxime and cefotaxime groups, 89.4% (110 of 123) versus 94.9% (93 of 98; p=0.140).

Conclusion: Cefuroxime, a second-generation cephalosporin, is an appropriate antibiotic option for the initial treatment of uncomplicated APN and its efficacy does not differ from cefotaxime, a third-generation cephalosporin, in the initial parenteral therapy for community-onset APN.

No MeSH data available.


Related in: MedlinePlus

A schematic diagram showing the subject selection and enrollment. Tx, therapy.
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Figure 1: A schematic diagram showing the subject selection and enrollment. Tx, therapy.

Mentions: Nine hundred and twelve women with community-onset APN were screened during the study period. Of these, 255 patients with community-onset uncomplicated APN due to E. coli who received cefuroxime or cefotaxime as the empirical antibiotic therapy were recruited (Fig. 1). Of these patients, 144 (56.5%) received cefuroxime and 111 (43.5%) received cefotaxime. Table 1 is a comparative chart of the baseline clinical characteristics, and treatment durations for the populations of the cefotaxime and cefuroxime groups. The median ages of the cefuroxime and cefotaxime groups were 41 (IQR, 31-51) years and 41 (IQR, 26-52) years, respectively (p=0.605) (Table 1). The patients in the two groups showed no significant differences in initial body temperature, costovertebral angle tenderness, flank pain, lower UTI symptoms, or the proportion of postmenopausal women. There were also no significant differences in previous history of UTI, prior history of hospitalization, or frequency of antibiotic usage within 12 months before the hospitalization between the cefotaxime and cefuroxime groups (Table 1).


Comparison of Second- and Third-Generation Cephalosporin as Initial Therapy for Women with Community-Onset Uncomplicated Acute Pyelonephritis.

Chang UI, Kim HW, Wie SH - Yonsei Med. J. (2015)

A schematic diagram showing the subject selection and enrollment. Tx, therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541656&req=5

Figure 1: A schematic diagram showing the subject selection and enrollment. Tx, therapy.
Mentions: Nine hundred and twelve women with community-onset APN were screened during the study period. Of these, 255 patients with community-onset uncomplicated APN due to E. coli who received cefuroxime or cefotaxime as the empirical antibiotic therapy were recruited (Fig. 1). Of these patients, 144 (56.5%) received cefuroxime and 111 (43.5%) received cefotaxime. Table 1 is a comparative chart of the baseline clinical characteristics, and treatment durations for the populations of the cefotaxime and cefuroxime groups. The median ages of the cefuroxime and cefotaxime groups were 41 (IQR, 31-51) years and 41 (IQR, 26-52) years, respectively (p=0.605) (Table 1). The patients in the two groups showed no significant differences in initial body temperature, costovertebral angle tenderness, flank pain, lower UTI symptoms, or the proportion of postmenopausal women. There were also no significant differences in previous history of UTI, prior history of hospitalization, or frequency of antibiotic usage within 12 months before the hospitalization between the cefotaxime and cefuroxime groups (Table 1).

Bottom Line: The rates of defervescence showed no significant differences in the two groups at 48, 72, 96, and 120 hours.The clinical cure rates observed at the follow-up visit 4 to 14 days after the completion of antimicrobial therapy were not statistically different between the cefuroxime and cefotaxime groups [94.9% (129 of 136) versus 98.0% (100 of 102), respectively; p=0.307], and the microbiological cure rates were also not significantly different [88.3% (91 of 103) versus 95.0% (76 of 80), respectively; p=0.186].Cefuroxime, a second-generation cephalosporin, is an appropriate antibiotic option for the initial treatment of uncomplicated APN and its efficacy does not differ from cefotaxime, a third-generation cephalosporin, in the initial parenteral therapy for community-onset APN.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Purpose: This study examined the clinical effectiveness of parenteral cefuroxime and cefotaxime as empirical antibiotics for treating hospitalized women with uncomplicated acute pyelonephritis (APN).

Materials and methods: This study was based on the clinical and microbiologic data of 255 hospitalized women with APN. Of these 255 women, 144 patients received cefuroxime and 111 received cefotaxime.

Results: There were no marked differences in the demographic features, clinical characteristics, and treatment duration between the populations of the cefuroxime and cefotaxime groups. The rates of defervescence showed no significant differences in the two groups at 48, 72, 96, and 120 hours. The clinical cure rates observed at the follow-up visit 4 to 14 days after the completion of antimicrobial therapy were not statistically different between the cefuroxime and cefotaxime groups [94.9% (129 of 136) versus 98.0% (100 of 102), respectively; p=0.307], and the microbiological cure rates were also not significantly different [88.3% (91 of 103) versus 95.0% (76 of 80), respectively; p=0.186]. The median hospitalization periods in the cefuroxime and cefotaxime groups were 7 (6-8) and 7 (6-8) days (p=0.157), respectively. Microbiological success rates after 72-96 hours of initial antimicrobial therapy were also not statistically different in the cefuroxime and cefotaxime groups, 89.4% (110 of 123) versus 94.9% (93 of 98; p=0.140).

Conclusion: Cefuroxime, a second-generation cephalosporin, is an appropriate antibiotic option for the initial treatment of uncomplicated APN and its efficacy does not differ from cefotaxime, a third-generation cephalosporin, in the initial parenteral therapy for community-onset APN.

No MeSH data available.


Related in: MedlinePlus