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Journal articles
Is 5 days of oral fluoroquinolone enough for acute uncomplicated pyelonephritis? The DTP randomized trial
A. Dinh
1
B. Davido
2
M. Etienne
3, 4
F. Bouchand
1
A. Raynaud-Lambinet
5
E. Aslangul-Castier
6
T. Szwebel
7
C. Duran
1
G. Der Sahakian
7
C. Jordy
8
X. Ranchoux
8
N. Sembach
9
E. Mathieu
10
A. Davido
9
J. Salomon
2, 10
L. Bernard
11
1
Hôpital Raymond Poincaré [AP-HP] (104 Boulevard Raymond Poincaré, 92380 Garches - France)
2
Service des Maladies Infectieuses et Tropicales [CHU Raymond Poincaré] (France)
- Hôpital Raymond Poincaré [AP-HP] (104 Boulevard Raymond Poincaré, 92380 Garches - France)
3
Service des maladies infectieuses et tropicales [Rouen] (France)
- CHU Rouen (1, rue de Germont 76031 Rouen cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
- UNIROUEN - Université de Rouen Normandie (1, rue Thomas Becket 76821 Mont-Saint-Aignan Cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
4
GRAM 2.0 - Groupe de Recherche sur l'Adaptation Microbienne (22 Bd Gambetta
76183 ROUEN CEDEX - France)
- UNIROUEN - Université de Rouen Normandie : EA 2656 (1, rue Thomas Becket 76821 Mont-Saint-Aignan Cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
- UNICAEN - Université de Caen Normandie (Esplanade de la Paix - CS 14032 - 14032 CAEN Cedex 5 - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
5
Hôpital de Rangueil (France)
- CHU Toulouse [Toulouse] (Hôtel-Dieu Saint Jacques 2, rue Viguerie TSA 80035 31059 Toulouse cedex 9 - France)
6
Service de médecine interne [HU Hotêl-Dieu] (France)
- AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) (France)
- Hôpital Hôtel-Dieu [Paris] (1, place du Parvis Notre-Dame 75004 Paris - France)
7
Hôpital Hôtel-Dieu [Paris] (1, place du Parvis Notre-Dame
75004 Paris - France)
8
CHV - Centre Hospitalier de Versailles André Mignot (Versailles, Trappes, Andrésy et Bois d'Arcy, Chesnay - France)
9
HEGP - Hôpital Européen Georges Pompidou [APHP] (20, rue Leblanc, 75015 Paris - France)
10
PhEMI - Pharmacoépidémiologie et maladies infectieuses (Département Infection et Epidémiologie
25-28, rue du Docteur Roux
75724 Paris cedex 15 - France)
- Institut Pasteur [Paris] (25-28, rue du docteur Roux, 75724 Paris cedex 15 - France)
- INSERM - Institut National de la Santé et de la Recherche Médicale : UMR 1181 (101, rue de Tolbiac, 75013 Paris - France)
11
Hôpital Bretonneau (France)
Abstract : The treatment duration of acute uncomplicated pyelonephritis (AUP) is still under debate. As shortening treatment duration could be a means to reduce antimicrobial resistance, we aimed to establish whether 5 days of antibiotic treatment is non-inferior to 10 days in patients with AUP. We performed an open-label prospective randomized trial comparing 5 days to 10 days of fluoroquinolone treatment for AUP. The inclusion criteria were: female patients aged ≥18 years with clinical signs of urinary tract infection, fever >38 °C, and positive urinalysis. Patients were randomized to either 5 or 10 days of fluoroquinolone treatment. Outcome was cure at day 10 and day 30 after the end of treatment. One hundred patients were randomized and 12 were excluded after randomization. The mean ± standard deviation (SD) age was 31.8 ± 11 years old and the mean ± SD temperature was 38.6 ± 0.7 °C. The main bacterium involved was Escherichia coli (n = 86; 97.7%) and 3 (3.4%) patients had a positive blood culture. In the post-hoc analysis, clinical cure 10 days after the end of the treatment was 28/30 (93.3%) in the 5-day arm and 36/38 (94.7%) in the 10-day arm (p = 1.00). At day 30, the clinical cure rate was 23/23 (100%) in the 5-day arm and 20/20 (100%) in the 10-day arm (p = 1.00). The microbiological cure rate was 20/23 (87.0%) in the 5-day arm and 16/20 (80.0%) in the 10-day arm (p = 1.00). The efficacy of 5 days of fluoroquinolone treatment does not seem different from 10 days of treatment for AUP.
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Journal articles
Complete list of metadata
https://hal-normandie-univ.archives-ouvertes.fr/hal-02372862
Contributor : Sandy Mzembaba Connect in order to contact the contributor
Submitted on : Wednesday, November 20, 2019 - 4:12:24 PM
Last modification on : Tuesday, October 19, 2021 - 11:35:04 PM
Contributor : Sandy Mzembaba Connect in order to contact the contributor
Submitted on : Wednesday, November 20, 2019 - 4:12:24 PM
Last modification on : Tuesday, October 19, 2021 - 11:35:04 PM
Identifiers
- HAL Id : hal-02372862, version 1
- DOI : 10.1007/s10096-017-2951-6
- PUBMED : 28283830
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Citation
A. Dinh, B. Davido, M. Etienne, F. Bouchand, A. Raynaud-Lambinet, et al.. Is 5 days of oral fluoroquinolone enough for acute uncomplicated pyelonephritis? The DTP randomized trial. European Journal of Clinical Microbiology and Infectious Diseases, Springer Verlag, 2017, 36 (8), pp.1443-1448. ⟨10.1007/s10096-017-2951-6⟩. ⟨hal-02372862⟩
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