[Comparative effectiveness of fluoroquinolones and beta-lactams in the complex therapy of patients with chronic...

A comparative study has evaluated the effect of fluoroquinolones and beta-lactams on clinical and biochemical manifestations of chronic pyelonephritis (CPN). 108 patients aged from 18 to 59 years (mean age - 40.26 +/- 10.09 years) with secondary CPN against dysmetabolic nephropathy and nephrolithiasis in a phase of active inflammation were observed. The majority of patients were women - 89 (82.4%). CPN was diagnosed in accordance with the N.A. Lopatkin and V.E. Rodoman clinical classification (1974) based on results of complete clinical and laboratory, radiologic and ultrasound examinations. Special methods of investigation included determination of the activity of lipid peroxidation, antioxidant system and the structural parameters of the cell membrane ofpolymorphonuclear leukocytes (PMN). Pain, dysuria, and intoxication syndrome were arrested in all patients after 14 days of therapy. The high efficacy was reported for patients treated with sparfloxacin. A similar trend was observed in the dynamics of intoxication syndrome regression. In addition, there was a significant reduction of lipid peroxidation products and an increase of alpha-tocopherol in the PMN membranes; the content of phospholipids significantly increased and cholesterol level declined during the treatment. The results showed that use of fluoroquinolones and the B-lactams in the treatment of patients with CPN against the nephrolithiasis leads to a significant relief of clinical symptoms of the disease, as well as to restoration the structural and functional state of PMN membranes. The most distinct and early clinical-laboratory effect was obtained against the background of use of fluoroquinolone sparfloxacin.