Intravenous cefuroxime as a first-line treatment for women hospitalized for pyelonephritis.

Autor:	Everard C; Service of Internal Medicine, Clinique Saint-Pierre, Ottignies, Belgium., Schampaert A; Service of Internal Medicine, Clinique Saint-Pierre, Ottignies, Belgium., Doyen L; Service of Internal Medicine, Clinique Saint-Pierre, Ottignies, Belgium., Verbelen V; Service of Microbiology, Clinique Saint Pierre, Ottignies, Belgium., Marot JC; Service of Internal Medicine, Clinique Saint-Pierre, Ottignies, Belgium., Wieërs G; Service of Internal Medicine, Clinique Saint-Pierre, Ottignies, Belgium.; Faculty of Medicine, Department of Medicine, URPC, Namur Research Institute for Life Sciences (NARILIS), University of Namur, Namur, Belgium.
Jazyk:	angličtina
Zdroj:	JAC-antimicrobial resistance [JAC Antimicrob Resist] 2024 May 06; Vol. 6 (3), pp. dlae071. Date of Electronic Publication: 2024 May 06 (Print Publication: 2024).
DOI:	10.1093/jacamr/dlae071
Abstrakt:	Background: Empirical treatment of pyelonephritis in the emergency ward includes broad-spectrum antibiotics. Such a strategy favours broad-spectrum antibiotic overuse. Local antibiotic stewardship teams can propose local recommendations to adapt empirical antibiotic treatment devoted to spare precious molecules that remain active on MDR bacteria, such as fluoroquinolones or other broad-spectrum antibiotics. Objectives: We aimed to evaluate the incidence of urinary tract infection recurrence within 3 months after hospital discharge following empirical antibiotic therapy with cefuroxime in women with pyelonephritis in the emergency room. Patients and Methods: We conducted a retrospective, single-centre study. We identified 109 women treated for pyelonephritis, 95 with cefuroxime at any time, and 14 with only other antibiotics, and divided them into subgroups based on antibiotic switch to other molecules. We compared the incidence of urinary tract infection recurrence in the subgroups. Results: In the group of patients treated with cefuroxime only, we identified five cases of recurrence (9.4%) in a total of 53 patients, but only 1 (1.9%) case of recurrence associated with the same uropathogen. No significant difference in clinical outcome, length of antibiotic treatment, or urinary tract infection recurrence was observed between the subgroups. Conclusions: Our study supports that a strategy elaborated by an antibiotic stewardship team based on local ecology and aimed at proposing the narrowest-spectrum antibiotic upon treatment initiation in the emergency room is safe. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)
Databáze:	MEDLINE
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