계명대학교 의학도서관 Repository

Clinical characteristics predicting early clinical failure after 72 h of antibiotic treatment in women with community-onset acute pyelonephritis: a prospective multicentre study

Metadata Downloads
Author(s)
S.-H. WieM. KiJ. KimY. K. ChoS.-K. LimJ. S. LeeK. T. KwonH. LeeH. J. CheongD. W. ParkS. Y. RyuM.-H. ChungH. Pai
Publication Year
2014
Abstract
In patients with community-onset acute pyelonephritis (CO-APN), assessing the risk factors for poor clinical response after 72 h of
antibiotic treatment (early clinical failure) is important. The objectives of this study were to define those risk factors, and to assess whether
early clinical failure influences mortality and treatment outcomes. We prospectively collected the clinical and microbiological data of women
with CO-APN in South Korea from March 2010 to February 2012. The numbers of cases in the early clinical success and early clinical failure
groups were 840 (79.1%) and 222 (20.9%), respectively. Final clinical failure and mortality were higher in the early clinical failure group than
in the early clinical success group (14.9% vs 2.3%, p <0.001; 6.8% vs 0.1%, p 0.001, respectively). In a multiple logistic regression model, the
risk factors for early clinical failure among the total 1062 patients were diabetes mellitus (OR 1.5; 95% CI 1.1–2.1), chronic liver diseases
(OR 3.3; 95% CI 1.6–6.7), malignancy (OR 2.2; 95% CI 1.1–4.4), Pitt score ≥2 (OR 2.5; 95% CI 1.6–3.8), presence of azotaemia (OR 1.8; 95%
CI 1.2–2.7), white blood cell count ≥20 000/mm3 (OR 2.5; 95% CI 1.6–4.0), serum C-reactive protein level ≥20 mg/dL (OR 1.7; 95% CI 1.2–
2.4), and history of antibiotic usage within the previous year (OR 1.5; 95% CI 1.1–2.2). Analysing the subgroup of 743 patients with CO-APN
due to Enterobacteriaceae, fluoroquinolone resistance of the uropathogen was another factor associated with early clinical failure (OR 1.7;
95% CI 1.1–2.5). Simple variables of underlying diseases, previous antibiotic usage and initial laboratory test outcomes can be used to decide
on the direction of treatment in CO-APN.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Clinical Microbiology and Infection, Vol.20(10) : 721-729, 2014
Type
Article
ISSN
1198-743X
DOI
10.1111/1469-0691.12500
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35453
Authorize & License
  • AuthorizeOpen
  • EmbargoForever
Files in This Item:

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.