First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review
Introduction: Complicated upper urinary tract infection (UTI) is a significant cause of infectious morbidity and in-hospital antibiotic therapy. However, the use of first-generation cephalosporins in this scenario is not clearly defined. Objective: To evaluate the efficacy and safety of first-genera...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-03-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971221012613 |
| _version_ | 1818872623988211712 |
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| author | Cándida Díaz-Brochero Martha Carolina Valderrama-Rios Laura Cristina Nocua-Báez Jorge Alberto Cortés |
| author_facet | Cándida Díaz-Brochero Martha Carolina Valderrama-Rios Laura Cristina Nocua-Báez Jorge Alberto Cortés |
| author_sort | Cándida Díaz-Brochero |
| collection | DOAJ |
| description | Introduction: Complicated upper urinary tract infection (UTI) is a significant cause of infectious morbidity and in-hospital antibiotic therapy. However, the use of first-generation cephalosporins in this scenario is not clearly defined. Objective: To evaluate the efficacy and safety of first-generation cephalosporins for community-acquired complicated upper UTI in adults requiring hospital care. Methods: Systematic review by searching electronic databases (MEDLINE, Embase, CENTRAL) and trials registers. The articles were then screened and the references were selected, data was extracted, and risk of bias assessment was conducted. The results are presented in a narrative synthesis. Results: Seven randomized clinical trials were included. We did not identify statistically significant differences when comparing first-generation cephalosporins with other antimicrobials for outcomes of clinical cure, length of hospital-stay, and reinfection. However, a lower probability of microbiological cure and a higher probability of relapse was identified in the first-generation cephalosporin group in 3 of 7 studies and in 2 of 5 studies, respectively. No serious adverse effects were reported. Conclusions: First-generation cephalosporins could be a potential therapy in this setting, nevertheless the low quality of evidence for analyzed outcomes should be considered because of the limitations of the risk of bias assessment and its inaccuracy. It is essential to carry out comparative studies in which the benefits and harms of these antibiotics are evaluated. |
| first_indexed | 2024-12-19T12:41:46Z |
| format | Article |
| id | doaj.art-d20cda7272024316bde2f8bba911508c |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-19T12:41:46Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-d20cda7272024316bde2f8bba911508c2022-12-21T20:20:57ZengElsevierInternational Journal of Infectious Diseases1201-97122022-03-01116403410First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature reviewCándida Díaz-Brochero0Martha Carolina Valderrama-Rios1Laura Cristina Nocua-Báez2Jorge Alberto Cortés3Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, y Hospital Universitario Nacional de ColombiaDepartment of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, y Hospital Universitario Nacional de ColombiaDepartment of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, y Hospital Universitario Nacional de ColombiaCorresponding author: Jorge Alberto Cortés, Clinical Research Office, National University Hospital of Colombia, Calle 44 # 59-75, First floor, Bogotá D.C., Colombia; Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, y Hospital Universitario Nacional de ColombiaIntroduction: Complicated upper urinary tract infection (UTI) is a significant cause of infectious morbidity and in-hospital antibiotic therapy. However, the use of first-generation cephalosporins in this scenario is not clearly defined. Objective: To evaluate the efficacy and safety of first-generation cephalosporins for community-acquired complicated upper UTI in adults requiring hospital care. Methods: Systematic review by searching electronic databases (MEDLINE, Embase, CENTRAL) and trials registers. The articles were then screened and the references were selected, data was extracted, and risk of bias assessment was conducted. The results are presented in a narrative synthesis. Results: Seven randomized clinical trials were included. We did not identify statistically significant differences when comparing first-generation cephalosporins with other antimicrobials for outcomes of clinical cure, length of hospital-stay, and reinfection. However, a lower probability of microbiological cure and a higher probability of relapse was identified in the first-generation cephalosporin group in 3 of 7 studies and in 2 of 5 studies, respectively. No serious adverse effects were reported. Conclusions: First-generation cephalosporins could be a potential therapy in this setting, nevertheless the low quality of evidence for analyzed outcomes should be considered because of the limitations of the risk of bias assessment and its inaccuracy. It is essential to carry out comparative studies in which the benefits and harms of these antibiotics are evaluated.http://www.sciencedirect.com/science/article/pii/S1201971221012613Complicated urinary tract infectionAcute pyelonephritisFirst-generation cephalosporinsEfficacySafetySystematic review |
| spellingShingle | Cándida Díaz-Brochero Martha Carolina Valderrama-Rios Laura Cristina Nocua-Báez Jorge Alberto Cortés First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review International Journal of Infectious Diseases Complicated urinary tract infection Acute pyelonephritis First-generation cephalosporins Efficacy Safety Systematic review |
| title | First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review |
| title_full | First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review |
| title_fullStr | First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review |
| title_full_unstemmed | First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review |
| title_short | First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review |
| title_sort | first generation cephalosporins for the treatment of complicated upper urinary tract infection in adults a systematic literature review |
| topic | Complicated urinary tract infection Acute pyelonephritis First-generation cephalosporins Efficacy Safety Systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S1201971221012613 |
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