Pyelonephritis treatment in the community emergency department: Cephalosporins vs. first-line agents

Vogler, Shaylyn; Pavich, Emily

doi:10.1016/j.ajem.2018.08.016

Cited by 13 publications

(4 citation statements)

References 12 publications

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“…Besides, our results about the clinical cure outcome are in line with the evidence provided by observational studies in patients with uncomplicated pyelonephritis, such as the retrospective cohort study conducted by Hobbs et al (Hobbs et al, 2016), in which cefazolin was not inferior compared to ceftriaxone. In contrast, another retrospective cohort study found an increased risk of therapeutic failure using TMP-SMX or fluoroquinolones compared to cephalosporins (Vogler and Pavich, 2018). Evidence from experimental studies has shown a favorable effect of first-generation cephalosporins in patients with uncomplicated pyelonephritis.…”

Section: Discussionmentioning

confidence: 96%

First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review

Díaz-Brochero

Valderrama-Rios

Nócua-Báez

et al. 2022

International Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 96%

First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review

Díaz-Brochero

Valderrama-Rios

Nócua-Báez

et al. 2022

International Journal of Infectious Diseases

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“…Furthermore, additional studies have been published since the IDSA guidelines in 2011 supporting efficacy of beta-lactams for the treatment of UTIs in adults. [32][33][34][35] The use of beta-lactams could be studied further to provide more potential treatment options, especially given that antibiotic resistance to many other antibiotic classes is on the rise.…”

Section: Discussionmentioning

confidence: 99%

Appropriateness of Antibiotic Prescriptions for Urinary Tract Infections

Chardavoyne

Kasmire

2020

WestJEM

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“…In some instances, such as treatment of a patient with an acute life‐threatening infection, direct de‐labeling of the penicillin allergy may not be feasible or practical and favored approaches might be: (a) utilization of a nonpenicillin (structurally dissimilar beta‐lactam or non–beta‐lactam) or (b) desensitization. At the point of care, if an allergy label is present and an alternative antimicrobial is available with no drop in treatment efficacy, use of that alternative agent may be an acceptable practice, but this is not true for all infections . An avoidance of penicillin leading to use of bacteriostatic, overly broad‐spectrum antimicrobials or less effective antibiotic, rather than a similar spectrum cephalosporin, is of higher concern.…”

Section: Current Approaches To Penicillin Allergy Labels and Penicillmentioning

confidence: 99%

“…At the point of care, if an allergy label is present and an alternative antimicrobial is available with no drop in treatment efficacy, use of that alternative agent may be an acceptable practice, 115 but this is not true for all infections. 114,116 An avoidance of penicillin leading to use of bacteriostatic, overly broad-spectrum antimicrobials or less effective antibiotic, rather than a similar spectrum cephalosporin, is of higher concern. There is now sufficient evidence to conclude that use of alternative antimicrobials is likely the primary pathway by which the associated harm and expense of a penicillin allergy label is mediated to patients.…”

Section: Role Of Desensitization and Alternative Antibioticsmentioning

confidence: 99%

The challenge of de‐labeling penicillin allergy

Stone

Trubiano

Coleman

et al. 2019

Allergy

186

160

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Background Even though 8%‐25% of most populations studied globally are labeled as penicillin allergic, most diagnoses of penicillin allergy are made in childhood and relate to events that are either not allergic in nature, are low risk for immediate hypersensitivity, or are a potential true allergy that has waned over time. Penicillin allergy labels directly impact antimicrobial stewardship by leading to use of less effective and broader spectrum antimicrobials and are associated with antimicrobial resistance. They may also delay appropriate antimicrobial therapy and lead to increased risk of specific adverse healthcare outcomes. Operationalizing penicillin allergy de‐labeling into a new arm of antimicrobial stewardship programs (ASPs) has become an increasing global focus. Methods We performed an evidence‐based narrative review of the literature of penicillin allergy label carriage, the adverse effects of penicillin allergy labels, and current approaches and barriers to penicillin allergy de‐labeling. Over the period 1928‐2018 in Pubmed and Medline, search terms used included “penicillin allergy” or “penicillin hypersensitivity” alone or in combination with “adverse events,” “testing,” “evaluation,” “effects,” “label,” “de‐labeling,” “prick or epicutaneous,” and “intradermal” skin testing, “oral challenge or provocation,” “cross‐reactivity,” and “antimicrobial stewardship”. Results Penicillin allergy labels are highly prevalent, largely inaccurate and their carriage may lead to unnecessary treatment and inferior outcomes with alternative agents as well as adverse public health outcomes such as antibiotic resistance. Conclusions Operationalizing penicillin allergy de‐labeling as an aspect of ASP has become an increasing global focus. There is a need for validated approaches that optimally combine the use of history and ingestion challenge with or without proceeding formal skin testing to tackle penicillin allergy efficiently within complex healthcare systems. At the same time, there is great promise for penicillin allergy evaluation and de‐labeling as an individual and public health strategy to reduce adverse healthcare outcomes, improve antimicrobial stewardship, and decrease healthcare costs.

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Pyelonephritis treatment in the community emergency department: Cephalosporins vs. first-line agents

Cited by 13 publications

References 12 publications

First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review

First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review

Appropriateness of Antibiotic Prescriptions for Urinary Tract Infections

The challenge of de‐labeling penicillin allergy

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