Short-course antibiotic Tx effective in acute pyelonephritis

July 18, 2012

Older women with acute pyelonephritis can be successfully and safely treated with oral ciprofloxacin (Cipro, Proquin) for 7 days, Swedish researchers report.

Older women with acute pyelonephritis can be successfully and safely treated with oral ciprofloxacin (Cipro, Proquin) for 7 days, Swedish researchers report.

In a study published online in The Lancet (June 20, 2012), the researchers set out to compare short-term efficacy and safety of a 7-day versus 14-day regimen. The prospective, randomized, double-blind, non-inferiority trial with parallel groups was conducted at 21 centers of infectious diseases in Sweden.

Between Feb. 1, 2006, and Dec. 31, 2008, investigators from Sahlgrenska University Hospital in Göteborg, Sweden enrolled 248 women who were 18 years of age and older and were presumed to have acute pyelonephritis. The patients were randomly assigned to receive oral treatment with ciprofloxacin, 500 mg twice daily for either 7 days or 14 days.

Results showed that cure rates were high for both regimens. Of the 126 patients who received treatment for 7 days, 73 were analyzed and 71 (97%) were cured. Of the 122 patients who received treatment for 14 days, 83 were analyzed and 80 (96%) were cured (difference –0.9%; 90% CI, –6.5 to 4.8; p=.004; non-inferiority test).

Both regimens were well tolerated and equally effective; however, the 14-day regimen was associated with more adverse events, noted the authors, led by Torsten Sandberg, MD.

"Our results show that community-acquired acute pyelonephritis in women can be treated successfully and safely with oral ciprofloxacin for 7 days and even in older patients and those with a more severe infection," the authors wrote.

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