The efficacy of sequential therapy using pazufloxacin followed by oral fluoroquinolones for treatment of pyelonephritis
2013
The efficacy of sequential therapy of
pazufloxacin(PZFX), which is a parenteral fluoroquinolone, followed by oral fluoroquinolones [
tosufloxacin tosilate(TFLX) or
levofloxacin(LVFX)] for treatment of pyelonephritis, was evaluated. Patients with pyelonephritis who had fever (≥37.5 °C),
pyuria(≥10 white blood cells/
high-power field), and
bacteriuria(≥104 colony-forming units/ml) were eligible for this study. PZFX (500 mg) was given intravenously twice a day for at least 3 days. If the patients were clinically improved, TFLX (150 mg) or LVFX (100 mg) was then administered orally three times a day for at least 5 days. Patients underwent clinical and
microbiologicalevaluation at 5–9 days after final drug administration. Clinical and
microbiologicalefficacy could be assessed in 21 of 25 cases enrolled. Both clinical and
microbiologicalefficacy rates were 81.0 % (17/21 cases). In the effective cases, the mean administration time was 4.2 days for PZFX and 6.0 days for oral fluoroquinolones. The mean time to defervescence was 3.4 days for the effective cases. In the four treatment failure cases, three
quinolone-resistant Escherichia coli and a
quinolone-resistant
Enterococcus faecaliswere isolated. This sequential therapy seemed to be clinically effective in the treatment of pyelonephritis; however, the prevalence of
quinolone-resistant E. coli should be taken into account.
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