[Acute pyelonephritis. Randomized multicenter double-blind study comparing ciprofloxacin with combined ciprofloxacin and tobramycin].
OBJECTIVE
To investigate the effects of an intravenous injection of tobramycin (T) in female patients with acute uncomplicated pyelonephritis treated with ciprofloxacin (CIP) (500 mg bid per os).


METHODS
It was a randomized, multicenter, double-blind study conducted in six departments of emergency medicine. The main exclusion criteria were: previous history of urinary tract malformation of lithiasis, a recent urological procedure, pregnancy, diabetes mellitus, immunodepression, or severe sepsis. The primary criteria for evaluation were: the percentage and rate of clinical recovery, as well as bacteriological efficacy.


RESULTS
118 women were enrolled, 60 in the tobramycin group and 58 in the placebo group. E. coli was the most commonly isolated organism; all organisms were susceptible to ciprofloxacin and tobramycin. Two women in the CIP + T group and four women in the CIP + P group failed to respond clinically. The recovery rate was similar in the two groups (96 and 93% respectively).


CONCLUSIONS
Administration of a dose of tobramycin did not demonstrate its clinical benefit in treatment of acute uncomplicated pyelonephritis treated by oral ciprofloxacin.
Le Conte
P
P
Service des Urgences, Centre Hospitalier et Universitaire, Nantes. pleconte@chu-nantes.fr
Simon
N
N
Bourrier
P
P
Merit
J B
JB
Lebrin
P
P
Bonnieux
J
J
Potel
G
G
Baron
D
D
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002939:Ciprofloxacin / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use; D004927:Escherichia coli Infections / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000188:drug therapy*; D014031:Tobramycin / Q000008:administration & dosage* / Q000009:adverse effects
D002939:Ciprofloxacin; D014031:Tobramycin
Pyélonéphrite aiguë. Etude randomisée multicentrique en double insu comparant la ciprofloxacine à l'association ciprofloxacine et tobramycine.