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Comparative Study
. 2024 Aug;43(8):1559-1567.
doi: 10.1007/s10096-024-04871-2. Epub 2024 Jun 10.

Oral quinolones versus intravenous β-lactam for the treatment of acute focal bacterial nephritis: a retrospective cohort study

L Aceituno  1   2 , A Nuñez-Conde  3 , J Serra-Pladevall  4 , B Viñado  5 , E Castella  6 , Laura Escolà-Vergé  7   8 , C Pigrau  9 , V Falcó  9 , Y O Len  10   9
Affiliations
Comparative Study

Oral quinolones versus intravenous β-lactam for the treatment of acute focal bacterial nephritis: a retrospective cohort study

L Aceituno et al. Eur J Clin Microbiol Infect Dis. 2024 Aug.

Abstract

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.

Keywords: Acute focal pyelonephritis; Quinolones; Urinary tract infections; Β-lactam.

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Figures

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Fig. 1
Flowchart of patient included in the study
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References

    1. Rosenfield AT, Glickman MG, Taylor KJ et al (1979) Acute focal bacterial nephritis (acute lobar nephronia). Radiology 132:553 10.1148/132.3.553 - DOI - PubMed
    1. Jiao S, Yan Z, Zhang C, Li J, Zhu J (2022) Clinical features of acute focal bacterial nephritis in adults. Sci Rep 12(1):1–5. 10.1038/s41598-022-10809-5 10.1038/s41598-022-10809-5 - DOI - PMC - PubMed
    1. Palou J, Pigrau C, Molina I, Ledesma JM, Angulo J (2011) Etiology and sensitivity of uropathogens identified in uncomplicated lower urinary tract infections in women (ARESC study): implications on empiric therapy. Med Clin (Barc) 136:1–7 10.1016/j.medcli.2010.02.042 - DOI - PubMed
    1. Johnson JR, Russo TA (2018) Acute pyelonephritis in adults. N Engl J Med 378(1):48–59 10.1056/NEJMcp1702758 - DOI - PubMed
    1. Farmer KD, Gellett LR, Dubbins PA (2002) The sonographic appearance of acute focal pyelonephritis 8 years experience. Clin Radiol 57(6):483–487 10.1053/crad.2002.0935 - DOI - PubMed

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