Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Decisions on treatment times with antibiotics are often arbitrary and based on empirical decisions or clinical trials which are too small to exclude even considerable differences between two study groups. Single-dose treatment of uncomplicated cystitis in women has been advocated by many but a careful analysis of available information clearly shows that a single-dose has so far always been inferior to 3-day or greater than 5-day treatment. With trimethoprim-sulphonamide combinations, no further efficacy is gained by increasing the treatment time in uncomplicated cystitis above three days while frequency of side effects increases drastically with extended treatment. In contrast, treatment with beta-lactams, for less than five days seems to result in unacceptable failure rates. In pyelonephritis there are few studies of the efficacy of antibiotic treatment for less than ten days. A comparison of two and six weeks' treatment showed no advantages with the extended time. There has also been a tendency towards reduced treatment times in upper respiratory tract infections such as streptococcal pharyngotonsillitis. However, two studies comparing 10-day treatment to 7-day and 5-day treatments, respectively, have clearly shown that the shorter treatment times give much higher rates of both clinical and bacteriological relapse. In more severe infections such as meningitis, no studies comparing treatment times have been carried out. It seems possible to use treatment for five days or less in meningococcal meningitis while other pathogens should be treated for ten days or longer. In endocarditis, the treatment time must vary with causative pathogens and can only rarely be shorter than four weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy and safety of antibiotic treatment in relation to treatment time. 209 14

The oral third-generation cephalosporin cefetamet pivoxil has a broad spectrum of antibacterial activity and favorable pharmacokinetic properties which makes it particularly suitable for the treatment of upper and lower respiratory tract infections as well as of infections of the urinary tract. The clinical trial results of cefetamet pivoxil have been reviewed from the literature in 4,112 patients out of whom 3,128 patients were treated with cefetamet pivoxil. The standard doses of cefetamet pivoxil, 500 mg twice daily in adults and 10 mg/kg twice daily in children, were at least as effective and in many cases clinically superior to most currently recommended antibiotics for the treatment of complicated urinary tract infections including pyelonephritis. High efficacy has also been demonstrated in patients with pneumonia, in acute exacerbation of chronic bronchitis and infections of the ear, nose and throat. Clinical trial results have shown that a 7-day treatment period with cefetamet pivoxil is as effective as a 10-day course of phenoxymethylpenicillin in the treatment of pharyngotonsillitis due to group A beta-hemolytic streptococci. Cefetamet pivoxil was well tolerated: 226 patients (7.2%) out of 3,128 had adverse events which were mainly gastrointestinal, i.e. diarrhea, nausea and vomiting. An additional 53 (1.7%) patients had laboratory changes which were of no clinical relevance. Premature treatment withdrawals were reported in 13 (0.5%) out of 2,612 adults and in 11 (2.1%) out of 516 children. All adverse events subsided rapidly after treatment. Many current antibiotic treatment regimens require the administration of three daily doses. However, twice daily standard doses of cefetamet pivoxil of 500 mg in adults or 10 mg/kg in children provide unbound plasma concentrations of cefetamet which generally exceed the MIC90 for susceptible organisms between doses and are clinically effective, well tolerated and should result in good compliance.
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PMID:Literature survey on clinical efficacy and tolerability on cefetamet pivoxil: an analysis of 3,128 cases. 848 90