title: Efficacy of treatment with carbapenems and third-generation cephalosporins for patients with febrile complicated pyelonephritis.
abstract: The purpose of this study was to clarify the clinical relevance of carbapenem and third-generation cephalosporin treatment for febrile complicated pyelonephritis, which often leads to urosepsis. Parenteral antimicrobial treatment with a carbapenem or third-generation cephalosporin was administered to febrile patients and the treatment was switched to oral antimicrobial agents after they became afebrile. In principle, the duration of the course of antimicrobial chemotherapy was limited to a total of 14 days. Clinically, the success rates were 97.3% in the carbapenem group and 96.0% in the third-generation cephalosporin group. For microbiological efficacy, the success rates were 89.2% in the carbapenem group and 92.0% in the third-generation cephalosporin group. There were no serious adverse events in the course of the study. The treatment regimen with a carbapenem or a third-generation cephalosporin was highly effective for patients with febrile complicated pyelonephritis and was well tolerated. Either of these regimens could become one of the standard treatments for patients with febrile complicated pyelonephritis.
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, 060-8543, Japan. stakahas@sapmed.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kurimura
authors.forename: Koh
authors.initials: K
authors.lastname: Takeyama
authors.forename: Kohei
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Shintaro
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Kohji
authors.initials: K
authors.lastname: Ichihara
authors.forename: Manabu
authors.initials: M
authors.lastname: Igarashi
authors.forename: Jiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Ryoji
authors.initials: R
authors.lastname: Furuya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hotta
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Uchida
authors.forename: Noriomi
authors.initials: N
authors.lastname: Miyao
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yanase
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takagi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tachiki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Taguchi
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000009:adverse effects / Q000627:therapeutic use*; D002511:Cephalosporins / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000382:microbiology / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000188:drug therapy* / Q000382:microbiology / Q000652:urine; D014556:Urine / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins