Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo

Background: Second generation cephalosporins (CFPs) are more active in the treatment of acute pyelonephritis during pregnancy but their cost is considerably higher than their predecessors. Cefuroxime, a second generation CFP with oral and parenteral presentations, might offer significant advantages...

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Autores principales:	Ovalle S,Alfredo, Martínez T,M Angélica, Wolff R,Marcelo, Cona T,Erna, Valderrama C,Oscar, Villablanca O,Ernesto, Lobos I,Luisa
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2000
Materias:	Cefuroxime Cephalosporins Cephradine Pregnancy complications, infections Pyelonephritis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000000700007
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spelling	oai:scielo:S0034-988720000007000072000-09-01Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazoOvalle S,AlfredoMartínez T,M AngélicaWolff R,MarceloCona T,ErnaValderrama C,OscarVillablanca O,ErnestoLobos I,Luisa Cefuroxime Cephalosporins Cephradine Pregnancy complications, infections Pyelonephritis Background: Second generation cephalosporins (CFPs) are more active in the treatment of acute pyelonephritis during pregnancy but their cost is considerably higher than their predecessors. Cefuroxime, a second generation CFP with oral and parenteral presentations, might offer significant advantages and become a first choice antimicrobial in this setting. Aim: To compare the efficacy, safety and cost of cefuroxime and cephradine in the treatment of acute pyelonephritis in pregnancy. Patients and methods: Hospitalized women with 12 to 34 weeks of pregnancy, with clinical and bacteriological diagnosis of acute pyelonephritis, were randomly assigned to receive cefuroxime (Curocef (r), GlaxoWellcome) 750 mg t.i.d, i.v or cephradine 1 g q.i.d., i.v. If the isolated organism was resistant to the assigned drug the patient was excluded. Once patients were afebrile, they were switched to an oral form of the same antimicrobial. They were discharged according to the clinical status and treated for a total of 14 days. Laboratory tests, including urine culture were requested during controls and at the end of follow-up at 28 days. Results: One hundred and one patients were randomized: 49 to receive cephradine and 52 to receive cefuroxime. Patients in the cefuroxime group had fewer febrile days (mean 1.7 vs 2.2, p<0.05), faster clinical recovery (mean 2.7 vs 3.1 days, p<0.05), a higher rate of bacteriological cure at 28 days (78.8% and 59.2%, p<0.05) and lower rate of failure (21.2% vs 40.8 % p<0.05). The rate of resistance of isolated uropathogens was l4% to cephradine and 1% to cefuroxime. Conclusions: Cefuroxime can be considered as a first choice option in the treatment of acute pyelonephritis during pregnancy due to its tolerance, microbiological activity and efficacy. (Rev Méd Chile 2000; 128: 749-57).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.128 n.7 20002000-07-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000000700007es10.4067/S0034-98872000000700007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Cefuroxime Cephalosporins Cephradine Pregnancy complications, infections Pyelonephritis
spellingShingle	Cefuroxime Cephalosporins Cephradine Pregnancy complications, infections Pyelonephritis Ovalle S,Alfredo Martínez T,M Angélica Wolff R,Marcelo Cona T,Erna Valderrama C,Oscar Villablanca O,Ernesto Lobos I,Luisa Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo
description	Background: Second generation cephalosporins (CFPs) are more active in the treatment of acute pyelonephritis during pregnancy but their cost is considerably higher than their predecessors. Cefuroxime, a second generation CFP with oral and parenteral presentations, might offer significant advantages and become a first choice antimicrobial in this setting. Aim: To compare the efficacy, safety and cost of cefuroxime and cephradine in the treatment of acute pyelonephritis in pregnancy. Patients and methods: Hospitalized women with 12 to 34 weeks of pregnancy, with clinical and bacteriological diagnosis of acute pyelonephritis, were randomly assigned to receive cefuroxime (Curocef (r), GlaxoWellcome) 750 mg t.i.d, i.v or cephradine 1 g q.i.d., i.v. If the isolated organism was resistant to the assigned drug the patient was excluded. Once patients were afebrile, they were switched to an oral form of the same antimicrobial. They were discharged according to the clinical status and treated for a total of 14 days. Laboratory tests, including urine culture were requested during controls and at the end of follow-up at 28 days. Results: One hundred and one patients were randomized: 49 to receive cephradine and 52 to receive cefuroxime. Patients in the cefuroxime group had fewer febrile days (mean 1.7 vs 2.2, p<0.05), faster clinical recovery (mean 2.7 vs 3.1 days, p<0.05), a higher rate of bacteriological cure at 28 days (78.8% and 59.2%, p<0.05) and lower rate of failure (21.2% vs 40.8 % p<0.05). The rate of resistance of isolated uropathogens was l4% to cephradine and 1% to cefuroxime. Conclusions: Cefuroxime can be considered as a first choice option in the treatment of acute pyelonephritis during pregnancy due to its tolerance, microbiological activity and efficacy. (Rev Méd Chile 2000; 128: 749-57).
author	Ovalle S,Alfredo Martínez T,M Angélica Wolff R,Marcelo Cona T,Erna Valderrama C,Oscar Villablanca O,Ernesto Lobos I,Luisa
author_facet	Ovalle S,Alfredo Martínez T,M Angélica Wolff R,Marcelo Cona T,Erna Valderrama C,Oscar Villablanca O,Ernesto Lobos I,Luisa
author_sort	Ovalle S,Alfredo
title	Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo
title_short	Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo
title_full	Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo
title_fullStr	Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo
title_full_unstemmed	Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo
title_sort	estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo
publisher	Sociedad Médica de Santiago
publishDate	2000
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000000700007
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Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo

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