Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura
ilustraciones, tablas
- Autores:
-
Diaz, Candida
- Tipo de recurso:
- Fecha de publicación:
- 2021
- Institución:
- Universidad Nacional de Colombia
- Repositorio:
- Universidad Nacional de Colombia
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unal.edu.co:unal/80024
- Palabra clave:
- Innovaciones en medicina
Infecciones del tracto urinario
Enfermedades del aparato urinario
Medical innovation
Urinary tract infections
Urinary organs -- Diseases
Pielonefritis aguda
Infeccion de vias urinarias complicada
Cefalosporinas de primera generación
Acute pyelonephritis
Complicated urinary tract infection
First generation cephalosporins
- Rights
- openAccess
- License
- Atribución-NoComercial-SinDerivadas 4.0 Internacional
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Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura |
| dc.title.translated.eng.fl_str_mv |
Effectiveness and safety of first-generation cephalosporins for treatment of upper complicated urinary tract infection in adults: a systematic review |
| title |
Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura |
| spellingShingle |
Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura Innovaciones en medicina Infecciones del tracto urinario Enfermedades del aparato urinario Medical innovation Urinary tract infections Urinary organs -- Diseases Pielonefritis aguda Infeccion de vias urinarias complicada Cefalosporinas de primera generación Acute pyelonephritis Complicated urinary tract infection First generation cephalosporins |
| title_short |
Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura |
| title_full |
Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura |
| title_fullStr |
Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura |
| title_full_unstemmed |
Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura |
| title_sort |
Cefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literatura |
| dc.creator.fl_str_mv |
Diaz, Candida |
| dc.contributor.advisor.none.fl_str_mv |
Cortes, Jorge Alberto |
| dc.contributor.author.none.fl_str_mv |
Diaz, Candida |
| dc.subject.lemb.spa.fl_str_mv |
Innovaciones en medicina Infecciones del tracto urinario Enfermedades del aparato urinario |
| topic |
Innovaciones en medicina Infecciones del tracto urinario Enfermedades del aparato urinario Medical innovation Urinary tract infections Urinary organs -- Diseases Pielonefritis aguda Infeccion de vias urinarias complicada Cefalosporinas de primera generación Acute pyelonephritis Complicated urinary tract infection First generation cephalosporins |
| dc.subject.lemb.eng.fl_str_mv |
Medical innovation Urinary tract infections Urinary organs -- Diseases |
| dc.subject.proposal.spa.fl_str_mv |
Pielonefritis aguda Infeccion de vias urinarias complicada Cefalosporinas de primera generación |
| dc.subject.proposal.eng.fl_str_mv |
Acute pyelonephritis Complicated urinary tract infection First generation cephalosporins |
| description |
ilustraciones, tablas |
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2021 |
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2021-08-26T04:42:07Z |
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2021-08-26T04:42:07Z |
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2021 |
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Trabajo de grado - Especialidad Médica |
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info:eu-repo/semantics/masterThesis |
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Universidad Nacional de Colombia |
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Repositorio Institucional Universidad Nacional de Colombia |
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https://repositorio.unal.edu.co/ |
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1. Tandogdu Z, Wagenlehner F. Global epidemiology of urinary tract infections. Curr Opin Infect Dis. 2016;29(1):73-9. https://doi.org/10.1097/QCO.0000000000000228. 2. Foxman B, Barlow R, D’Arcy H, et al. Urinary tract infection: self-reported incidence and associated costs. Ann Epidemiol 2000; 10:509–515. 3. Johansen, T. E., Botto, H., Cek, M., Grabe, M., Tenke, P., Wagenlehner, F. M., & Naber, K. G. Critical review of current definitions of urinary tract infections and proposal of an EAU/ESIU classification system. Int J Antimicrob Agents 2011; 38 Suppl, 64-70. doi:10.1016/j.ijantimicag.2011.09.009 4. Neal, D. E., Jr. Complicated urinary tract infections. Urol Clin North Am 2008; 35(1), 13-22; v. doi:10.1016/j.ucl.2007.09.010 5. Klein, R.D., Hultgren, S.J. Urinary tract infections: microbial pathogenesis, host–pathogen interactions and new treatment strategies. Nat Rev Microbiol 18, 211–226 (2020). https://doi.org/10.1038/s41579-020-0324-0 6. Kang, C.I., Kim J., Won Park D., Kim B., Ha U., (2018) Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections Infect Chemother 2018;50:67-100 7. Kalpana Gupta, Thomas M. Hooton, Kurt G. Naber, Bjorn Wullt, Richard Colgan, Loren G. Miller.. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical Infectious Diseases, Volume 52, Issue 5, 1 March 2011, Pages e103–e120, https://doi.org/10.1093/cid/ciq257 8. Menday AP. Comparison of pivmecillinam and cephalexin in acute uncomplicated urinary tract infection. Int J Antimicrob Agents. 2000;13(3):183-7. http://doi.org/dqknmz. 9. Scottish Intercollegiate Guidelines Network. (SIGN). Management of suspected bacterial urinary tract infection in adults. Edinburgh: SIGN; 2012. 10. Skerk V, Andrasevic AT, Andrasevic S, Susic E, Dzepina AM, Madaric V, et al. ISKRA guidelines on antimicrobial treatment and prophylaxis of urinary tract infections-Croatian national guidelines. Lijec Vjesn. 2009;131(5-6):105-18. 11. National Institute for Health and Care Excellence (2018). Pyelonephritis (acute): antimicrobial prescribing. Disponible en: https://www.nice.org.uk/guidance/ng111 12. Consenso Argentino Intersociedades de Infección Urinaria 2018-2019 - Parte I. Medicina (B Aires) 2020;80(3):229-240 13. Higgins_JP, Sterne_JA, Savovic_J, Page_MJ, Hróbjartsson_A, Boutron_I, et al. A revised tool for assessing risk of bias in randomized trials. In: Chandler J, McKenzie J, Boutron I, Welch V, editor(s). Cochrane Methods. Cochrane Database of Systematic Reviews 2016;(10 (Suppl 1)). (DOI: 10.1002/14651858.CD201601) 14. Tramacere I, Del Giovane C, Salanti G, D’Amico R, Filippini G. Immunomodulators and immunosuppressants for relapsing-remitting multiple sclerosis: a network metaanalysis. Cochrane Database of Systematic Reviews 2015, Issue 9. DOI: 10.1002/14651858.CD011381.pub2 15. Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629-634. doi:10.1136/bmj.315.7109.629 16. Harbord, R. M., Egger, M., & Sterne, J. A. (2006). A modified test for small-study effects in meta-analyses of controlled trials with binary endpoints. Stat Med, 25(20), 3443-3457. doi:10.1002/sim.2380 17. Guyatt, G., Oxman, A. D., Akl, E. A., Kunz, R., Vist, G., Brozek, J., . . . Schunemann, H. J. (2011). GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 64(4), 383-394. doi:10.1016/j.jclinepi.2010.04.026 18. M Gurwith, W Albritton, B Lank, G Harding, A Ronald. Prospective comparison of cefoxitin and cefazolin in infections caused by aerobic bacteria. Antimicrob Agents Chemother 1978 Feb;13(2):255-60. doi: 10.1128/AAC.13.2.255. 19. U Hoyme, P O Madsen. Cefamandole and cefazolin in the therapy of complicated urinary tract infections. J Infect Dis 1978 May;137 Suppl:S100-S102. doi: 10.1093/infdis/137.supplement.s100. 20. A. Scott Lea, Arthur W. Sudan, Bruce A. Wood, Layne 0. Gentry. Randomized Comparative Study of Moxalactam and Cefazolin in the Treatment of Acute Urinary Tract Infections in Adults. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, July 1982, p. 32-35 Vol. 22, No. 1 21. P O Madsen, P Iversen. Cefotaxime and cefazolin in the treatment of complicated urinary tract infections: a comparative study. Clin Ther 1981;4(1):7-11. 22. M Ohkawa, K Kuroda. A double-blind clinical trial of cefotaxime and cefazolin in complicated urinary tract infections. J Antimicrob Chemother 1980 Sep;6 Suppl A:231-3. doi: 10.1093/jac/6.suppl_a.231. 23. T Sandberg, G Englund, K Lincoln, L G Nilsson. Randomised double-blind study of norfloxacin and cefadroxil in the treatment of acute pyelonephritis. Eur J Clin Microbiol Infect Dis 1990 May;9(5):317-23. doi: 10.1007/BF01973737. 24. Athena L. V. Hobbs, Katherine M. Shea, Mitchell J. Daley, R. Gordon Huth, Theresa C. Jaso. Are first-generation cephalosporins obsolete? A retrospective, non-inferiority, cohort study comparing empirical therapy with cefazolin versus ceftriaxone for acute pyelonephritis in hospitalized patients. J Antimicrob Chemother doi:10.1093/jac/dkw035 25. Shaylyn Vogler, Emily Pavich. Pyelonephritis treatment in the community emergency department: Cephalosporins vs. first-line agents. Am J Emerg Med 2018 Nov;36(11):2054-2057. doi: 10.1016/j.ajem.2018.08.016. Epub 2018 Aug 8. 26. D L Hyslop, W Bischoff. Loracarbef (LY163892) versus cefaclor and norfloxacin in the treatment of uncomplicated pyelonephritis. Am J Med 1992 Jun 22;92(6A):86S-94S. DOI: 10.1016/0002-9343(92)90614-h. 27. Azadeh Ebrahimzadeh, Seyed Alireza Saadatjoo, Azadeh Alipoor Tabrizi. Comparing ceftriaxone and cefazolin for treatment of adult acute pyelonephritis; A clinical trial. Iranian Journal of Clinical Infectious Diseases 2010;5(2):75-79 ©2010 IDTMRC, Infectious Diseasand Tropical Medicine Research Center 28. Clinical and Laboratory Standards Institutes. Performance standards for antimicrobial susceptibility testing. Twentyfirst informational supplement. M100eS21. Wayne, PA: CLSI; 2011. 29. EUCAST General Consultation on Enterobacterales breakpoints for Cefazolin Consultation closed 8 November 2019. |
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41 páginas |
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Universidad Nacional de Colombia |
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Bogotá - Medicina - Especialidad en Medicina Interna |
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Departamento de Medicina Interna |
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Facultad de Medicina |
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Bogotá, Colombia |
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Universidad Nacional de Colombia - Sede Bogotá |
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Atribución-NoComercial-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Cortes, Jorge Albertod121d5da8b5b4a1e3ab74b70e1c83158Diaz, Candidaf8ce30038dd0eaa14c381e1eb87332132021-08-26T04:42:07Z2021-08-26T04:42:07Z2021https://repositorio.unal.edu.co/handle/unal/80024Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, tablasIntroducción: La infección de vías urinarias (IVU) alta complicada es una causa importante de morbilidad infecciosa con requerimiento de hospitalización. Las cefalosporinas de primera generación son recomendadas para el manejo de pielonefritis por diferentes sociedades, sin embargo, el rol de estos medicamentos en las infecciones complicadas persiste sin explorarse completamente. Objetivo: Evaluar la eficacia y seguridad del tratamiento con cefalosporinas de primera generación en adultos con IVU alta complicada adquirida en la comunidad que requieran manejo hospitalario. Métodos: Se realizó una revisión sistemática de la literatura. La búsqueda de evidencia se realizó en las bases de datos MEDLINE vía Ovid, EMBASE, y el Registro Cochrane Central de Ensayos Controlados (CENTRAL) en enero de 2021. Dos revisores de forma independiente realizaron la selección de referencias elegibles por título, resumen y posteriormente texto completo; extracción de datos y evaluación del riesgo de sesgos. Se presentaron los resultados como odds ratio (OR) con sus intervalos de confianza del 95%. Resultados: Se identificaron seis ensayos clínicos aleatorizados para ser incluidos, con un total de 542 pacientes. No se identificaron diferencias con el uso de cefalosporinas de primera generación en comparación con otros antimicrobianos para los desenlaces de cura clínica, duración de la estancia hospitalaria y reinfección. En cuanto al desenlace de cura microbiológica, se evidenció un mayor chance de ocurrencia con el uso de otros grupos de antimicrobianos en 3 de los 6 estudios. Para el desenlace de recaída se identificó un mayor chance de recaída con el uso de cefalosporinas de primera generación en 2 de 4 estudios que evaluaron este desenlace. No se reportaron efectos adversos serios con el uso de cefalosporinas de primera generación en ninguno de los 3 estudios incluidos para este desenlace. El riesgo de sesgos de los estudios se valoró como moderado y alto, lo que condicionó la baja calidad de la evidencia para todos los desenlaces. Conclusiones: Las cefalosporinas de primera generación son antibióticos con una eficacia clínica similar a los comparadores. Podría existir una mayor riesgo de falla microbiológica con el uso de estos medicamentos. Los estudios incluídos son de hace más de 30 años por lo que su utilidad en las condiciones actuales de uso y resistencia podría ser limitada. Sería importante realizar estudios comparativos en los que se evalúe la real utilidad de estos medicamentos en este escenario. (Texto tomado de la fuente)Introduction: Complicated upper urinary tract infection (UTI) is an important cause of infectious morbidity requiring hospitalization. First-generation cephalosporins are recommended for the management of pyelonephritis by different societies, however, the role of these drugs in complicated infections remains unexplored. Objective: To evaluate the efficacy and safety of treatment with first generation cephalosporins in adults with complicated discharge acquired in the community that require hospital management. Methods: A systematic review of the literature was carried out. The search for evidence was performed in the databases MEDLINE via Ovid, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) in January 2021. Two reviewers independently screened eligible references by title, abstract and subsequently text complete; data extraction and assessment of risk of bias. The results were presented as odds ratio (OR) with their 95% confidence intervals. Results: Six randomized clinical trials were identified for inclusion, with a total of 542 patients. No differences were identified with the use of first-generation cephalosporins compared to other antimicrobials for clinical cure outcomes, length of hospital stay, and reinfection. Regarding the outcome of microbiological cure, a greater chance of occurrence was evidenced with the use of other groups of antimicrobials in 3 of the 6 studies. For the relapse outcome, a greater chance of relapse was identified with the use of first-generation cephalosporins in 2 of 4 studies that evaluated this outcome. No serious adverse effects were reported with the use of first generation cephalosporins in any of the 3 studies included for this outcome. The risk of bias of the studies was assessed as moderate and high, which conditioned the low quality of the evidence for all outcomes. Conclusions: First-generation cephalosporins are antibiotics with similar clinical efficacy to comparators. There could be an increased risk of microbiological failure with the use of these drugs. The included studies are from more than 30 years ago, so their usefulness in the current conditions of use and resistance could be limited. It would be important to carry out comparative studies in which the real usefulness of these drugs in this scenario is evaluated.Especialidades MédicasMédico internistaRevisión sistemática de la literatura41 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en Medicina InternaDepartamento de Medicina InternaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede BogotáCefalosporinas de primera generación para el tratamiento de la infección urinaria alta complicada en adultos: Revisión sistemática de la literaturaEffectiveness and safety of first-generation cephalosporins for treatment of upper complicated urinary tract infection in adults: a systematic reviewTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TM1. Tandogdu Z, Wagenlehner F. Global epidemiology of urinary tract infections. Curr Opin Infect Dis. 2016;29(1):73-9. https://doi.org/10.1097/QCO.0000000000000228. 2. Foxman B, Barlow R, D’Arcy H, et al. Urinary tract infection: self-reported incidence and associated costs. Ann Epidemiol 2000; 10:509–515. 3. Johansen, T. E., Botto, H., Cek, M., Grabe, M., Tenke, P., Wagenlehner, F. M., & Naber, K. G. Critical review of current definitions of urinary tract infections and proposal of an EAU/ESIU classification system. Int J Antimicrob Agents 2011; 38 Suppl, 64-70. doi:10.1016/j.ijantimicag.2011.09.009 4. Neal, D. E., Jr. Complicated urinary tract infections. Urol Clin North Am 2008; 35(1), 13-22; v. doi:10.1016/j.ucl.2007.09.010 5. Klein, R.D., Hultgren, S.J. Urinary tract infections: microbial pathogenesis, host–pathogen interactions and new treatment strategies. Nat Rev Microbiol 18, 211–226 (2020). https://doi.org/10.1038/s41579-020-0324-0 6. Kang, C.I., Kim J., Won Park D., Kim B., Ha U., (2018) Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections Infect Chemother 2018;50:67-100 7. Kalpana Gupta, Thomas M. Hooton, Kurt G. Naber, Bjorn Wullt, Richard Colgan, Loren G. Miller.. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical Infectious Diseases, Volume 52, Issue 5, 1 March 2011, Pages e103–e120, https://doi.org/10.1093/cid/ciq257 8. Menday AP. Comparison of pivmecillinam and cephalexin in acute uncomplicated urinary tract infection. Int J Antimicrob Agents. 2000;13(3):183-7. http://doi.org/dqknmz. 9. Scottish Intercollegiate Guidelines Network. (SIGN). Management of suspected bacterial urinary tract infection in adults. Edinburgh: SIGN; 2012. 10. Skerk V, Andrasevic AT, Andrasevic S, Susic E, Dzepina AM, Madaric V, et al. ISKRA guidelines on antimicrobial treatment and prophylaxis of urinary tract infections-Croatian national guidelines. Lijec Vjesn. 2009;131(5-6):105-18. 11. National Institute for Health and Care Excellence (2018). Pyelonephritis (acute): antimicrobial prescribing. Disponible en: https://www.nice.org.uk/guidance/ng111 12. Consenso Argentino Intersociedades de Infección Urinaria 2018-2019 - Parte I. Medicina (B Aires) 2020;80(3):229-240 13. Higgins_JP, Sterne_JA, Savovic_J, Page_MJ, Hróbjartsson_A, Boutron_I, et al. A revised tool for assessing risk of bias in randomized trials. In: Chandler J, McKenzie J, Boutron I, Welch V, editor(s). Cochrane Methods. Cochrane Database of Systematic Reviews 2016;(10 (Suppl 1)). (DOI: 10.1002/14651858.CD201601) 14. Tramacere I, Del Giovane C, Salanti G, D’Amico R, Filippini G. Immunomodulators and immunosuppressants for relapsing-remitting multiple sclerosis: a network metaanalysis. Cochrane Database of Systematic Reviews 2015, Issue 9. DOI: 10.1002/14651858.CD011381.pub2 15. Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629-634. doi:10.1136/bmj.315.7109.629 16. Harbord, R. M., Egger, M., & Sterne, J. A. (2006). A modified test for small-study effects in meta-analyses of controlled trials with binary endpoints. Stat Med, 25(20), 3443-3457. doi:10.1002/sim.2380 17. Guyatt, G., Oxman, A. D., Akl, E. A., Kunz, R., Vist, G., Brozek, J., . . . Schunemann, H. J. (2011). GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 64(4), 383-394. doi:10.1016/j.jclinepi.2010.04.026 18. M Gurwith, W Albritton, B Lank, G Harding, A Ronald. Prospective comparison of cefoxitin and cefazolin in infections caused by aerobic bacteria. Antimicrob Agents Chemother 1978 Feb;13(2):255-60. doi: 10.1128/AAC.13.2.255. 19. U Hoyme, P O Madsen. Cefamandole and cefazolin in the therapy of complicated urinary tract infections. J Infect Dis 1978 May;137 Suppl:S100-S102. doi: 10.1093/infdis/137.supplement.s100. 20. A. Scott Lea, Arthur W. Sudan, Bruce A. Wood, Layne 0. Gentry. Randomized Comparative Study of Moxalactam and Cefazolin in the Treatment of Acute Urinary Tract Infections in Adults. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, July 1982, p. 32-35 Vol. 22, No. 1 21. P O Madsen, P Iversen. Cefotaxime and cefazolin in the treatment of complicated urinary tract infections: a comparative study. Clin Ther 1981;4(1):7-11. 22. M Ohkawa, K Kuroda. A double-blind clinical trial of cefotaxime and cefazolin in complicated urinary tract infections. J Antimicrob Chemother 1980 Sep;6 Suppl A:231-3. doi: 10.1093/jac/6.suppl_a.231. 23. T Sandberg, G Englund, K Lincoln, L G Nilsson. Randomised double-blind study of norfloxacin and cefadroxil in the treatment of acute pyelonephritis. Eur J Clin Microbiol Infect Dis 1990 May;9(5):317-23. doi: 10.1007/BF01973737. 24. Athena L. V. Hobbs, Katherine M. Shea, Mitchell J. Daley, R. Gordon Huth, Theresa C. Jaso. Are first-generation cephalosporins obsolete? A retrospective, non-inferiority, cohort study comparing empirical therapy with cefazolin versus ceftriaxone for acute pyelonephritis in hospitalized patients. J Antimicrob Chemother doi:10.1093/jac/dkw035 25. Shaylyn Vogler, Emily Pavich. Pyelonephritis treatment in the community emergency department: Cephalosporins vs. first-line agents. Am J Emerg Med 2018 Nov;36(11):2054-2057. doi: 10.1016/j.ajem.2018.08.016. Epub 2018 Aug 8. 26. D L Hyslop, W Bischoff. Loracarbef (LY163892) versus cefaclor and norfloxacin in the treatment of uncomplicated pyelonephritis. Am J Med 1992 Jun 22;92(6A):86S-94S. DOI: 10.1016/0002-9343(92)90614-h. 27. Azadeh Ebrahimzadeh, Seyed Alireza Saadatjoo, Azadeh Alipoor Tabrizi. Comparing ceftriaxone and cefazolin for treatment of adult acute pyelonephritis; A clinical trial. Iranian Journal of Clinical Infectious Diseases 2010;5(2):75-79 ©2010 IDTMRC, Infectious Diseasand Tropical Medicine Research Center 28. Clinical and Laboratory Standards Institutes. Performance standards for antimicrobial susceptibility testing. Twentyfirst informational supplement. M100eS21. Wayne, PA: CLSI; 2011. 29. EUCAST General Consultation on Enterobacterales breakpoints for Cefazolin Consultation closed 8 November 2019.Innovaciones en medicinaInfecciones del tracto urinarioEnfermedades del aparato urinarioMedical innovationUrinary tract infectionsUrinary organs -- DiseasesPielonefritis agudaInfeccion de vias urinarias complicadaCefalosporinas de primera generaciónAcute pyelonephritisComplicated urinary tract infectionFirst generation cephalosporinsEspecializadaUniversidad Nacional de ColombiaLICENSElicense.txtlicense.txttext/plain; charset=utf-83964https://repositorio.unal.edu.co/bitstream/unal/80024/7/license.txtcccfe52f796b7c63423298c2d3365fc6MD57ORIGINALManuscrito RS C1G ITU Complicada. REPOSITORIO.pdfManuscrito RS C1G ITU Complicada. 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