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.
Angel
J L
JL
Department of Obstetrics and Gynecology, University of South Florida, College of Medicine, Tampa.
O'Brien
W F
WF
Finan
M A
MA
Morales
W J
WJ
Lake
M
M
Knuppel
R A
RA
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