Empirical Therapy of Complicated Pyelonephritis

The aim of the research was to analyze the effectiveness of empirical therapy in patients with established complicated upper urinary tract infection (complicated pyelonephritis).Materials and methods. 51 patients who were treated in 2018 in the urological department of the Irkutsk City Clinical Hosp...

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Autores principales:	V. A. Beloborodov, V. A. Vorobev, P. V. Opanasyuk
Formato:	article
Lenguaje:	RU
Publicado:	Scientific Сentre for Family Health and Human Reproduction Problems 2019
Materias:	pyelonephritis complicated pyelonephritis chronic pyelonephritis empirical antibacterial therapy Science Q
Acceso en línea:	https://doaj.org/article/e08ceb7da19b436bbe97872254c364d1
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id	oai:doaj.org-article:e08ceb7da19b436bbe97872254c364d1
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spelling	oai:doaj.org-article:e08ceb7da19b436bbe97872254c364d12021-11-23T06:14:43ZEmpirical Therapy of Complicated Pyelonephritis2541-94202587-959610.29413/ABS.2019-4.5.4https://doaj.org/article/e08ceb7da19b436bbe97872254c364d12019-11-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/2164https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596The aim of the research was to analyze the effectiveness of empirical therapy in patients with established complicated upper urinary tract infection (complicated pyelonephritis).Materials and methods. 51 patients who were treated in 2018 in the urological department of the Irkutsk City Clinical Hospital N 1 were subjected to a retrospective study. The average age of patients was 55.9 ± 16.9 years.Results. Successful empirical therapy was considered in the absence of correction of the treatment regimen and the normalization of clinical blood and urine tests. Of the patients included in the study, successful empirical therapy was found in 24 (47%) patients, and required correction in 27 (52.9 %) patients. Cephalosporins as monotherapy were ineffective in 24 (57.1 %) patients, carbopenems – in one (25 %), fluoroquinolones – in all (100 %). Aminoglycosides showed the best result as a combination therapy with cephalosporins – 100 % (n = 3) of success. Based on multivariate logistic regression analysis, it was established that the detection of microhematuria and uremia in clinical analyzes upon admission to the hospital increases the likelihood of empirical monotherapy with third-generation cephalosporins by 20 % and 27 %, respectively.Conclusion. It is advisable to refrain from the use of monotherapy with fluoroquinolones and third-generation cephalosporins until more information is available about the resistance of uropathogens in the population of the Irkutsk region. Patients with impaired renal function require particularly close attention of the clinician when choosing a scheme for the empirical treatment of complicated pyelonephritis.V. A. BeloborodovV. A. VorobevP. V. OpanasyukScientific Сentre for Family Health and Human Reproduction Problemsarticlepyelonephritiscomplicated pyelonephritischronic pyelonephritisempirical antibacterial therapyScienceQRUActa Biomedica Scientifica, Vol 4, Iss 5, Pp 26-30 (2019)
institution	DOAJ
collection	DOAJ
language	RU
topic	pyelonephritis complicated pyelonephritis chronic pyelonephritis empirical antibacterial therapy Science Q
spellingShingle	pyelonephritis complicated pyelonephritis chronic pyelonephritis empirical antibacterial therapy Science Q V. A. Beloborodov V. A. Vorobev P. V. Opanasyuk Empirical Therapy of Complicated Pyelonephritis
description	The aim of the research was to analyze the effectiveness of empirical therapy in patients with established complicated upper urinary tract infection (complicated pyelonephritis).Materials and methods. 51 patients who were treated in 2018 in the urological department of the Irkutsk City Clinical Hospital N 1 were subjected to a retrospective study. The average age of patients was 55.9 ± 16.9 years.Results. Successful empirical therapy was considered in the absence of correction of the treatment regimen and the normalization of clinical blood and urine tests. Of the patients included in the study, successful empirical therapy was found in 24 (47%) patients, and required correction in 27 (52.9 %) patients. Cephalosporins as monotherapy were ineffective in 24 (57.1 %) patients, carbopenems – in one (25 %), fluoroquinolones – in all (100 %). Aminoglycosides showed the best result as a combination therapy with cephalosporins – 100 % (n = 3) of success. Based on multivariate logistic regression analysis, it was established that the detection of microhematuria and uremia in clinical analyzes upon admission to the hospital increases the likelihood of empirical monotherapy with third-generation cephalosporins by 20 % and 27 %, respectively.Conclusion. It is advisable to refrain from the use of monotherapy with fluoroquinolones and third-generation cephalosporins until more information is available about the resistance of uropathogens in the population of the Irkutsk region. Patients with impaired renal function require particularly close attention of the clinician when choosing a scheme for the empirical treatment of complicated pyelonephritis.
format	article
author	V. A. Beloborodov V. A. Vorobev P. V. Opanasyuk
author_facet	V. A. Beloborodov V. A. Vorobev P. V. Opanasyuk
author_sort	V. A. Beloborodov
title	Empirical Therapy of Complicated Pyelonephritis
title_short	Empirical Therapy of Complicated Pyelonephritis
title_full	Empirical Therapy of Complicated Pyelonephritis
title_fullStr	Empirical Therapy of Complicated Pyelonephritis
title_full_unstemmed	Empirical Therapy of Complicated Pyelonephritis
title_sort	empirical therapy of complicated pyelonephritis
publisher	Scientific Сentre for Family Health and Human Reproduction Problems
publishDate	2019
url	https://doaj.org/article/e08ceb7da19b436bbe97872254c364d1
work_keys_str_mv	AT vabeloborodov empiricaltherapyofcomplicatedpyelonephritis AT vavorobev empiricaltherapyofcomplicatedpyelonephritis AT pvopanasyuk empiricaltherapyofcomplicatedpyelonephritis
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Empirical Therapy of Complicated Pyelonephritis

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