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Doses greater than those recommended for each condition have either not demonstrated additional efficacy or have not been studied. At the end of 6 weeks, no patient in the truncated treatment arm required retreatment, whereas 1 patient in the continued treatment arm was retreated.
Upper bound of the difference 6. Patients in the truncated treatment arm had significantly shorter hospital stay 8 vs.
Conclusion Stopping the effective non-FQ antibiotics following clinical improvement at Day 7 is non-inferior to continued treatment until Day 14 in selected patients with APN requiring hospitalization.
Citation: Rudrabhatla P, Deepanjali S, Mandal J, Swaminathan RP, Kadhiravan T Stopping the effective non-fluoroquinolone antibiotics at day 7 vs continuing until day 14 in adults with acute pyelonephritis requiring hospitalization: A randomized non-inferiority trial.
Data Availability: All relevant data are within the paper and its Supporting Information files. JIPMER is a publicly-funded hospital that provides free treatment to patients, including the trial participants.
Introduction Acute pyelonephritis APN is one of the most common community-acquired infections requiring treatment with antibiotics. Traditionally, the duration of treatment for APN has been 10—14 days. Based on recent trials, current clinical guidelines recommend shorter regimens of fluoroquinolones FQs for 5—7 days to treat uncomplicated APN in non-pregnant women in the outpatient setting.
While several clinical trials in the past had compared the clinical efficacy of these agents with another antibiotic such as FQs in patients with APN, none of the trials assessed the optimal duration of treatment regimens using non-FQ antibiotics other than co-trimoxazole; trials on hospitalized APN patients are particularly lacking.
The variables included in the model were selected by means of a backward-forward stepwise procedure on a restricted set of covariates selected according to the results of univariate analysis.
The coefficients of the logistic equation were estimated with the maximum likelihood method, and the hypothesis of the equality to 0 of these coefficients was tested by use of a likelihood ratio.