Empirical treatment in patients with acute obstructive pyelonephritis

Infectious Disorders Drug Targets
Sergii PasiechnikovOleg Banyra

Abstract

Acute obstructive pyelonephritis (AOP) is a urological life-threatening inflammatory condition that initially requires immediate urinary drainage and simultaneous prescribing of highly effective targeted antibacterial treatment. The empirical antibacterial therapy is always prescribed before urine culture and susceptibility testing are done. Percutaneous nephrostomy (PNS) and ureteral stenting (US) are the two options for urinary drainage in obstructed kidneys, while fluoroquinolones and 3(rd) generation cephalosporins are the main groups of antibacterial drugs that are recommended and are available for empirical AOP therapy. In our study we aimed to compare efficacy of fluoroquinolone ciprofloxacin vs 3(rd) generation cephalosporin ceftazidime in empirical antibacterial treatment of patients with acute obstructive pyelonephritis. We also tried to analyze the impact of urinary drainage option on cure rates. 241 AOP patients were randomized into two groups: Group 1, n=124 pts in whom percutaneous nephrostomy was performed urinary drainage and Group 2, n=117 pts, in whom ureteral stenting was made. Then each abovementioned group was also randomized into equal two subgroups (ciprofloxacin vs ceftazidime) depending on the empiric a...Continue Reading

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