Systematic review on the choice of antibiotics for management of complicated urinary tract bacterial infections and acute pyelonephritis

AbstractThe management of complicated urinary tract infections has been limited, with suboptimal success, treatment failure, recurrent infection, and the development of resistant bacterial strains. We reviewed the antimicrobial efficacy and safety and the microbial resistance of antibiotics for complicated urinary tract infections. This systematic review of 11 randomized controlled trials assessed the overall success rate and clinical cure rate of various antibiotics compared with conventional alternatives. Among the articles meeting inclusion criteria, we identified nine different agents, including ceftazidime –avibactam, ceftolozane–tazobactam, sitafloxacin, relebactam, meropenem–vaborbactam, plazomicin, finafloxacin, intravenous fosfomycin, and sulbactam–durlobactam. Various conventional therapies were used in the control groups, including imipenem–cilastatin, levofloxacin, doripenem, ertapene m, piperacillin–tazobactam, ciprofloxacin, ceftriaxone, and cefdinir. All authors of the included trials concluded that their study drugs were noninferior or equivalent to more conventional alternatives. Similarly, the drugs were well-tolerated compared with conventional alternatives. These findin gs indicate that antibiotic regimens may improve clinical practice in the management of complicated urinary tract infections and acute pyelonephritis by offering new alternatives for patients infected with highly resistant bacterial strains.
Source: Drugs and Therapy Perspectives - Category: Drugs & Pharmacology Source Type: research