Acute pyelonephritis in pregnancy: a prospective study of oral versus intravenous antibiotic therapy.
Ninety pregnant women admitted to the high-risk pregnancy unit with a diagnosis of acute pyelonephritis were randomized to receive either oral (cephalexin 500 mg every 6 hours) or intravenous (IV) (cephalothin 1 g every 6 hours) antibiotic therapy. All patients were initially hydrated with 1 L of normal saline IV over 4 hours. Neither parenteral analgesics nor antiemetics were used. Bacteremia was noted in 13 (14.4%) of the 90 patients and mandated IV therapy. There was no difference between the oral and IV groups concerning predefined criteria for successful therapy (91.4 versus 92.9% successful therapy, respectively). No characteristic available at presentation predicted bacteremia or ultimate failure of therapy. Two patients (2.2%) experienced significant complications. These data suggest that in nonbacteremic patients, oral antibiotics are both safe and effective for the treatment of acute pyelonephritis in pregnancy.
Department of Obstetrics and Gynecology, University of South Florida, College of Medicine, Tampa.
J L
JL
Angel
W F
WF
O'Brien
M A
MA
Finan
W J
WJ
Morales
M
M
Lake
R A
RA
Knuppel
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007902:Length of Stay; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D011704:Pyelonephritis / Q000188:drug therapy* / Q000382:microbiology; D011897:Random Allocation
D000900:Anti-Bacterial Agents