Stopping the effective non-fluoroquinolone antibiotics at day 7 vs continuing until day 14 in adults with acute pyelonephritis requiring hospitalization: A randomized non-inferiority trial

PloS One
Pavankumar RudrabhatlaTamilarasu Kadhiravan

Abstract

To evaluate whether stopping the effective antibiotic treatment following clinical improvement at Day 7 (Truncated treatment) would be non-inferior to continued treatment until Day 14 (Continued treatment) in patients with acute pyelonephritis (APN) requiring hospitalization treated with non-fluoroquinolone (non-FQ) antibiotics. Hospitalized adult men and non-pregnant women with culture-confirmed APN were eligible for participation after they had clinically improved following empirical or culture-guided treatment with intravenous non-FQ antibiotic(s). We excluded patients with severe sepsis, abscesses, prostatitis, recurrent or catheter-associated urinary tract infection, or urinary tract obstruction. We randomized eligible patients on Day 7 of effective treatment and assessed them at Weeks 1 and 6 after treatment completion. The primary outcome was retreatment for recurrent urinary tract infection. The prespecified non-inferiority margin was 15%. Between March 17, 2015 and August 22, 2016, we randomly allocated 54 patients-27 patients in each arm. Twenty-four (44%) patients were male, and 26 (48%) had diabetes mellitus. Escherichia coli was the most common urinary isolate (47 [87%] patients); 36 (78%) were resistant to ciprofl...Continue Reading

References

Nov 1, 1992·The Journal of Antimicrobial Chemotherapy·D A Leigh
May 1, 1990·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·T SandbergL G Nilsson
Sep 1, 1987·Annals of Internal Medicine·R R Bailey, B A Peddie
Dec 10, 1999·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J W WarrenW E Stamm
Dec 13, 2003·Chemotherapy·Konstantin CharalabopoulosNikolaos Sofikitis
Nov 4, 2004·American Journal of Epidemiology·Moran KiBetsy Foxman
Apr 9, 2005·BMJ : British Medical Journal·Douglas G Altman, J Martin Bland
Feb 6, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lionel A MandellUNKNOWN American Thoracic Society
Mar 4, 2008·Obstetrics and Gynecology·UNKNOWN American College of Obstetricians and Gynecologists
Mar 25, 2010·BMJ : British Medical Journal·David MoherDouglas G Altman
May 13, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Benjamin A LipskyChristopher T Hoey
Feb 5, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kalpana GuptaUNKNOWN European Society for Microbiology and Infectious Diseases
Sep 2, 2011·Current Infectious Disease Reports·Willize E van der StarreCees van Nieuwkoop
Nov 17, 2011·Critical Care : the Official Journal of the Critical Care Forum·Thomas C HaveyNick Daneman
Aug 14, 2013·Antimicrobial Agents and Chemotherapy·Krishan P SinghLinda M Mundy
Jan 16, 2016·The Korean Journal of Internal Medicine·Sung-Yeon ChoJin-Hong Yoo
Apr 16, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Tamar F BarlamKavita K Trivedi
Feb 15, 2017·Antimicrobial Agents and Chemotherapy·Haley J MorrillKerry L LaPlante
Aug 16, 2017·Antimicrobial Agents and Chemotherapy·J MeletiadisUNKNOWN the SATURN Diagnostic Study Group
Dec 23, 2017·Journal of Chemotherapy·Annarita MazzariolGiuseppe Cornaglia
Jan 4, 2018·The New England Journal of Medicine·James R Johnson, Thomas A Russo

❮ Previous
Next ❯

Citations

Nov 6, 2020·Current Opinion in Infectious Diseases·Benjamin J SmithKirsty Buising
Jul 3, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Miranda SoShahid Husain

❮ Previous
Next ❯

Methods Mentioned

BETA
urine microscopy

Software Mentioned

MinimPy
Stata
OPAT
NCSS
IC

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antimicrobial Resistance

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Aminoglycosides (ASM)

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.

Antimicrobial Resistance (ASM)

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Carbapenems (ASM)

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Aminoglycosides

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.

Carbapenems

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.