Authors
Abstract
Background and Purpose: There have been variations on the response rate of microorganisms causing pyelonephritis to antibiotics in different studies. The present study was conducted to compare the drug resistance against Ceftriaxone and Cefazolin in adult acute pyelonephritis. Methods and Materials: In this phase-3 single blind clinical trial 86 patients suffering from pyelonephritis were selected through successive sampling and were randomly assigned into one of the two groups after they signed an informed consent: Ceftriaxone 1g every 12 hours and IV Cefazolin 1g every 8 hours. Seventy two hours after the onset of treatment patients were examined for their clinical and laboratory resistance. The obtained data were analyzed in SPSS using chi-square test independent sample t-test and Kappa coefficient. Results: Mean fever alleviation time were 2.63±0.95 and 2.77±0.81 days in the ceftriaxone and cefazolin groups respectively (p=0.2). Urinary culture 72 hours after treatment was positive in 7% of patients in both groups. In the ceftriaxone group 51.2% of the patients were sensitive clinically and in the laboratory results. In total 9.3% were sensitive in laboratory and clinically resistant; and 39.5% were sensitive in laboratory despite being clinically resistant. With the cefazolin group 51.2% were both clinically and laboratory sensitive; and 7% were clinically and laboratory resistant; also 11.6% were sensitive in laboratory but clinically resistant; but 30.2% were clinically sensitive despite being resistant in the laboratory results. Conclusion: In the treatment of non-complicated upper urinary infections the therapeutic effect of cefazolin is not different from that of ceftriaxone which is broad spectrum and more expensive.
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