Pivmecillinam Treatment of Community-Acquired Uncomplicated Pyelonephritis Based on Sparse Data
Journal Title: Global Journal of Infectious Diseases and Clinical Research - Year 2015, Vol 1, Issue 1
Abstract
Background: Pivmecillinam has good pharmacokinetic properties for treatment of infections in the urinary tract, and the mecillinam resistance rate in Enterobacteriaceae is very low. In a European guideline pivmecillinam is recommended as a first-line drug for treatment of lower urinary tract infections. In Danish and Norwegian guidelines pivmecillinam is also recommended for acute uncomplicated pyelonephritis, although with very sparse documentation of effect. Objectives: We intended to investigate the therapeutic outcome of pivmecillinam treatment of uncomplicated pyelonephritis caused by Enterobacteriaceae treated by general practitioners (GP’s) in primary care. Material and methods: We included patients clinically diagnosed with pyelonephritis at the GP, urine samples positive for Enterobacteriaceae and empirical treatment with pivmecillinam. We intended to include patients prospectively, but due to slow inclusion we also included patients retrospectively. The prospectively included patients were asked to fill out a questionnaire and submit control urine samples. The retrospectively included patients were followed by available urine samples and the text on the requisition only. The patients were followed by their urine samples for three months. Results: We identified 22 patients (i.e. six patients prospectively and found another 16 patients retrospectively). Bacterial and clinical cure rate was 77% (95%c.i.: 60-95%), respectively. In seven (32%) of the patients, we observed a recurrent or new infection within three months. Conclusion: There is indication for safe oral treatment with pivmecillinam in uncomplicated pyelonephritis caused by a mecillinam susceptible E. coli. More studies and especially prospective and randomized clinical studies are needed before pivmecillinam can be recommended as first line option for treatment of pyelonephritis.
Authors and Affiliations
Jansaker Filip, Hertz Frederik Boetius, Frimodt-Moller Niels, Knudsen Jenny Dahl
Keywords
Related Articles
- EP ID EP334699
- DOI 10.17352/2455-5363.000004
- Views 89
- Downloads 0
Leishmaniasis during the increased Syrian refugee traffic
Especially in recent years, important population mobility occurs worldwide, including refugee crisis affecting especially Middle East and Europe. Consequently, like other infectious diseases have significance for public...
Antibacterial Effects of Herbal Compounds against Acinetobacter baumannii Isolated from Hospital of Tehran, Iran
Increasing isolation of multidrug-resistant Acinetobacter baumannii (MDR) has been reported in worldwide and it is recently one of the most difficult nosocomial acquired gram-negative pathogens to control and treatment....
Sero-Prevalence of Hepatitis B and Hepatitis C Viruses among Tuberculosis Patients in Kassala, Eastern Sudan
Background: Hepatitis B (HBV) and hepatitis C (HCV)virus infection is a major concern among tuberculous (TB) patients, thus early screening of these viruses will influence the outcome of the disease. Methods: A cross-sec...
Sero-prevalence of Hepatitis B and C virus and High Risk of Hepatotoxicity among TB/HIV Positive and HIV Negative Population in Western Cameroon
Background: Hepatitis and HIV are the most common co-infections in tuberculosis (TB) patients and may have an effect on the liver enzymes in these co-infected TB patients. This study aimed to determine the prevalence of...
Arthroscopic treatment for Intraarticular knee infection in Hanoi Medical University Hospital
Objectives: 1) Describe the arthroscopic image of infected osteoarthritis of knee; 2) Evaluate the result of arthroscopic treatment for infected osteoarthritis of knee Patients and method: Retrospective study 33 patients...