Sistema de Salut de Catalunya
Institut Català de la Salut
[Aceituno L] Unitat del Fetge, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Nuñez-Conde A] Internal Medicine Department, Mútua Terrassa University Hospital, Terrassa, Barcelona, Spain. [Serra-Pladevall J] Microbiology Department, Vic Hospital, Vic, Spain. [Viñado B] Servei de Microbiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Castella E] Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Escolà-Vergé L] Infectious Diseases Unit, Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. CIBERINFEC, Instituto de Salud Carlos III, Barcelona, Spain. [Pigrau C, Falcó V] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Len O] CIBERINFEC, Instituto de Salud Carlos III, Barcelona, Spain. Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2024-08-21T07:38:26Z
2024-08-21T07:38:26Z
2024-06-10
Acute focal pyelonephritis; Quinolones; Urinary tract infections
Pielonefritis focal aguda; Quinolones; Infeccions del tracte urinari
Pielonefritis focal aguda; Quinolonas; Infecciones del tracto urinario
Background Evidence regarding the best antibiotic regimen and the route of administration to treat acute focal bacterial nephritis (AFBN) is scarce. The aim of the present study was to compare the effectiveness of intravenous (IV) β-lactam antibiotics versus oral quinolones. Methods This is a retrospective single centre study of patients diagnosed with AFBN between January 2017 and December 2018 in Hospital Universitari Vall d’Hebron, Barcelona (Spain). Patients were identified from the diagnostic codifications database. Patients treated with oral quinolones were compared with those treated with IV β-lactam antibiotics. Therapeutic failure was defined as death, relapse, or evolution to abscess within the first 30 days. Results A total of 264 patients fulfilled the inclusion criteria. Of those, 103 patients (39%) received oral ciprofloxacin, and 70 (26.5%) IV β-lactam. The most common isolated microorganism was Escherichia coli (149, 73.8%) followed by Klebsiella pneumoniae (26, 12.9%). Mean duration of treatment was 21.3 days (SD 7.9). There were no statistical differences regarding therapeutic failure between oral quinolones and IV β-lactam treatment (6.6% vs. 8.7%, p = 0.6). Out of the 66 patients treated with intravenous antibiotics, 4 (6.1%) experienced an episode of phlebitis and 1 patient (1.5%) an episode of catheter-related bacteraemia. Conclusions When susceptible, treatment of AFBN with oral quinolones is as effective as IV β-lactam treatment with fewer adverse events.
Open Access Funding provided by Universitat Autonoma de Barcelona.
Article
Published version
English
Avaluació de resultats (Assistència sanitària); Malalties bacterianes - Tractament; Medicaments antibacterians - Ús terapèutic; CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents; Other subheadings::Other subheadings::/therapeutic use; DISEASES::Bacterial Infections and Mycoses::Bacterial Infections; Other subheadings::Other subheadings::Other subheadings::/drug therapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome; COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos; Otros calificadores::Otros calificadores::/uso terapéutico; ENFERMEDADES::infecciones bacterianas y micosis::infecciones bacterianas; Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento
Springer
European Journal of Clinical Microbiology & Infectious Diseases;43
https://doi.org/10.1007/s10096-024-04871-2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
