PMID: 9181655Jan 1, 1997Paper

Aminoglycosides do not improve the efficacy of cephalosporins for treatment of acute pyelonephritis in women

Scandinavian Journal of Infectious Diseases
T SandbergA M Olinder-Nielsen

Abstract

A prospective, coordinated, randomized multicentre trial was conducted to determine whether tobramycin 160 mg intravenously (i.v.) once daily for 2 days would improve the efficacy of cefotaxime 1 g i.v. twice daily for 2 days followed by a 10-day course of oral cefadroxil 1 g twice daily, in the treatment of community-acquired acute pyelonephritis in women. Of 73 patients enrolled in the study, 51 could be evaluated according to the protocol. There were no significant differences in bacteriological cure rates between the combined treatment with tobramycin/cefotaxime and cefotaxime alone, either at short-term follow-up (63.0% vs 59.1%; 95% confidence interval (CI) for difference in proportions -23.4% to 31.2%), or up to 7 weeks after cessation of treatment (42.9% vs 52.2%; 95% CI, -18.0% to 36.6%). A modified intention-to-treat analysis showed no difference in clinical efficacy between the two regimens (68.6% vs 69.2%; 95% CI, -22.9% to 24.1%). Tobramycin seemed to enhance the resolution of inflammation by a more rapid decline in C-reactive protein levels. The high recurrence rates after treatment with beta-lactam antibiotics in this and previous studies of acute pyelonephritis may be explained by adverse ecological effects rath...Continue Reading

References

Aug 1, 1977·Journal of Medical Microbiology·G Lidin-JansonK Lincoln
May 1, 1990·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·T SandbergL G Nilsson
Jan 1, 1985·The Journal of Antimicrobial Chemotherapy·M G Bergeron
Oct 1, 1993·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·J WinbergC E Nord

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Citations

Jun 29, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ioannis A BliziotisMatthew E Falagas
Feb 5, 2011·International Journal of Antimicrobial Agents·Ronit MarcusLeonard Leibovici
Jul 21, 2006·International Journal of Antimicrobial Agents·Giorgina B PiccoliG Piccoli
Jan 8, 2014·The Cochrane Database of Systematic Reviews·Mical PaulLeonard Leibovici
May 22, 2018·Open Forum Infectious Diseases·Jesse D SuttonEmily S Spivak
Oct 26, 1999·Annals of Emergency Medicine·D A Talan

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