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Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

34
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
34
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
25
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

38
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
38
Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

101
A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
101
Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

76
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
76
Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

33
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
33

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Updated: Aug 29, 2025

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
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Sulopenem for the Treatment of Complicated Urinary Tract Infections Including Pyelonephritis: A Phase 3, Randomized

Michael W Dunne1, Steven I Aronin1, Anita F Das2

  • 1Iterum Therapeutics, Old Saybrook, Connecticut, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 7, 2022
PubMed
Summary

Sulopenem did not prove non-inferior to ertapenem for complicated urinary tract infections (cUTIs). While well-tolerated, sulopenem showed a lower response rate, particularly in asymptomatic bacteriuria cases.

Keywords:
acute pyelonephritiscomplicated urinary tract infectionsulopenem

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Sulopenem is a novel thiopenem antibiotic developed for multidrug-resistant infections.
  • Both intravenous (IV) and oral formulations are available, potentially enabling earlier hospital discharge.

Purpose of the Study:

  • To evaluate the non-inferiority of sulopenem compared to ertapenem in treating complicated urinary tract infections (cUTIs).
  • To assess the efficacy and safety of IV and oral sulopenem formulations.

Main Methods:

  • A randomized trial involving hospitalized adults with cUTIs.
  • Patients received 5 days of IV sulopenem or IV ertapenem, followed by oral step-down therapy.
  • Primary endpoint was the combined clinical and microbiologic response at day 21.

Main Results:

  • Sulopenem (67.8%) was not non-inferior to the comparator regimen (73.9%) for the primary endpoint.
  • The difference was primarily due to a lower rate of asymptomatic bacteriuria in the ertapenem group receiving ciprofloxacin.
  • Both sulopenem formulations demonstrated favorable tolerability compared to the comparator.

Conclusions:

  • Sulopenem did not meet non-inferiority criteria for cUTI treatment compared to ertapenem.
  • The observed difference was linked to asymptomatic bacteriuria rates in specific subgroups.
  • Sulopenem exhibited good tolerability in both IV and oral forms.