ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2019
A pharmacokinetic-pharmacodynamic assessment of oral antibiotics for pyelonephritis.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
- Management of Gram-Negative Bloodstream Infections With Oral Antibiotics in Solid Organ Transplant Recipients.Clinical transplantation · 2026Observational
- Narrow spectrum, broad utility: Reassessing cephalexin and cefazolin beyond cellulitis.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2025Article
- Oral Cephalexin Population Pharmacokinetics and Target Attainment Analysis in Infants 7-60 Days Old.Journal of the Pediatric Infectious Diseases Society · 2025Article
- Amoxicillin-Clavulanate Breakpoints Against Enterobacterales: Rationale for Revision by the Clinical and Laboratory Standards Institute.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Evaluation of Oral Amoxicillin/Clavulanate for Urinary Tract Infections Caused by Ceftriaxone Non-Susceptible Enterobacterales.Pharmacy (Basel, Switzerland) · 2024Article
- Oral Antibiotics for Bacteremia and Infective Endocarditis: Current Evidence and Future Perspectives.Microorganisms · 2023Review
- Clinical Impact of Oral Step-Down Therapy for Gram-Negative Bacteremia: A Retrospective Study.HCA healthcare journal of medicine · 2023Article
- Outcomes of high-dose oral beta-lactam definitive therapy compared to fluoroquinolone or trimethoprim-sulfamethoxazole oral therapy for bacteremia secondary to a urinary tract infection.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- A retrospective review of oral cephalosporins versus fluoroquinolones for the treatment of pyelonephritis.PloS one · 2022Article
- Optimizing the Management of Uncomplicated Gram-Negative Bloodstream Infections: Consensus Guidance Using a Modified Delphi Process.Open forum infectious diseases · 2021Article
- Orally Administered Amoxicillin/Clavulanate: Current Role in Outpatient Therapy.Infectious diseases and therapy · 2021Article
- Oral β-Lactam Antibiotics vs Fluoroquinolones or Trimethoprim-Sulfamethoxazole for Definitive Treatment of Enterobacterales Bacteremia From a Urine Source.JAMA network open · 2020Article
- Process Development and Synthesis of Process-Related Impurities of an Efficient Scale-Up Preparation of 5,2'-Dibromo-2,4',5'-Trihydroxy Diphenylmethanone as a New Acute Pyelonephritis Candidate Drug.Molecules (Basel, Switzerland) · 2020Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
Antibiotic resistance to oral antibiotics recommended for pyelonephritis is increasing. The objective was to determine if there is a pharmacological basis to consider alternative treatments/novel dosing regimens for the oral treatment of pyelonephritis. A systematic review identified pharmacokinetic models of suitable quality for a selection of antibiotics with activity against Escherichia coli. MIC data was obtained for a population of E. coli isolates derived from patients with pyelonephritis. Pharmacokinetic/pharmacodynamic (PK/PD) simulations determined probability of target attainment (PTA) and cumulative fraction response (CFR) values for sub-populations of the E. coli population at varying doses. There are limited high-quality models available for the agents investigated. Pharmacokinetic models of sufficient quality for simulation were identified for amoxicillin, amoxicillin-clavulanic acid, cephalexin, ciprofloxacin, and fosfomycin trometamol. These antibiotics were predicted to have PTAs ≥ 0.85 at or below standard doses for the tested E. coli population including cephalexin 1500 mg 8 hourly for 22% of the population (MIC ≤ 4 mg/L) and ciprofloxacin 100 mg 12 hourly for 71% of the population (MIC ≤ 0.06 mg/L). For EUCAST-susceptible E. coli isolates, doses achieving CFRs ≥ 0.9 included amoxicillin 2500 mg 8 hourly, cephalexin 4000 mg 6 hourly, ciprofloxacin 200 mg 12 hourly, and 3000 mg of fosfomycin 24 hourly. Limitations in the PK data support carrying out additional PK studies in populations of interest. Oral antibiotics including amoxicillin, amoxicillin-clavulanic acid, and cephalexin have potential to be effective for a proportion of patients with pyelonephritis. Ciprofloxacin may be effective at lower doses than currently prescribed.
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