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[Acute pyelonephritis. Randomized multicenter double-blind study comparing ciprofloxacin with combined ciprofloxacin
P Le Conte1, N Simon, P Bourrier
1Service des Urgences, Centre Hospitalier et Universitaire, Nantes. pleconte@chu-nantes.fr
Objectives:
To investigate the effects of an intravenous injection of tobramycin (T) in female patients with acute uncomplicated pyelonephritis treated with ciprofloxacin (CIP) (500 mg bid per os).
Methods:
It was a randomized, multicenter, double-blind study conducted in six departments of emergency medicine. The main exclusion criteria were: previous history of urinary tract malformation of lithiasis, a recent urological procedure, pregnancy, diabetes mellitus, immunodepression, or severe sepsis. The primary criteria for evaluation were: the percentage and rate of clinical recovery, as well as bacteriological efficacy.
Results:
118 women were enrolled, 60 in the tobramycin group and 58 in the placebo group. E. coli was the most commonly isolated organism; all organisms were susceptible to ciprofloxacin and tobramycin. Two women in the CIP + T group and four women in the CIP + P group failed to respond clinically. The recovery rate was similar in the two groups (96 and 93% respectively).
Conclusion:
Administration of a dose of tobramycin did not demonstrate its clinical benefit in treatment of acute uncomplicated pyelonephritis treated by oral ciprofloxacin.