{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:16:52Z","timestamp":1772691412844,"version":"3.50.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002537"],"award-info":[{"award-number":["UL1TR002537"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Mayo Midwest Pharmacy Research Committee"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Urinary tract infections (UTIs) are commonly treated in the emergency department (ED), and unfortunately, resistance to first-line agents is increasing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To characterize treatment of pyelonephritis in a nationally representative sample of ED patients and to identify patient- and treatment-specific factors associated with receiving initial inactive antibiotics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a multicentre, observational cohort study utilizing the Emergency Medicine PHARMacotherapy Research NETwork (EMPHARM-NET), comprising 15 geographically diverse US EDs. All patients \u226518\u2005years of age with a diagnosis of pyelonephritis between 2018 and 2020 were included. The primary endpoint was the proportion of patients who received initial inactive empirical antibiotic therapy and to identify predictive factors of inactive antibiotic therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 3714 patients evaluated, 223 had culture-positive pyelonephritis. Median patient age was 50.1\u2005years and patients were mostly female (78.3%). Overall, 40.4% of patients received an IV antibiotic, most commonly ceftriaxone (86.7%). The most frequently prescribed antibiotics were cefalexin (31.8%), ciprofloxacin (14.3%), cefdinir (13.5%) and trimethoprim\/sulfamethoxazole (12.6%). Overall, 10.3% of patients received initial inactive therapy. After adjustment in a multivariable analysis, long-acting IV antibiotic was predictive of inactive therapy (OR 0.23, 95% CI 0.07\u20130.83).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In our prospective, multicentre observational study, we found that only 40.4% of patients with pyelonephritis received empirical IV antibiotics in the ED, contributing to inactive therapy. Receipt of long-acting IV antibiotics was independently associated with a decreased rate of initial inactive therapy. This reinforces guideline recommendations to administer long-acting IV antibiotics empirically in the ED upon suspicion of pyelonephritis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae070","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T08:32:09Z","timestamp":1710405129000},"page":"1038-1044","source":"Crossref","is-referenced-by-count":6,"title":["Empirical antimicrobial prescribing for pyelonephritis in patients discharged from 15 US Emergency Departments: an opportunity for improvement"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-518X","authenticated-orcid":false,"given":"Megan A","family":"Rech","sequence":"first","affiliation":[{"name":"Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare Edward Hines, Jr. VA Hospital , 5000 South 5th Ave, Hines, IL 60141 ,","place":["USA"]},{"name":"Department of Emergency Medicine, Loyola University Medical Center, 2160 S 1st Ave , Maywood, IL 60153 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett A","family":"Faine","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Pharmacy, University of Iowa Hospitals and Clinics , 200 Hawkins Dr., Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9352-8389","authenticated-orcid":false,"given":"Alan E","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy , 833 S Wood St, Chicago, IL 60612 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6419-3433","authenticated-orcid":false,"given":"Priyanka","family":"Vakkalanka","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Pharmacy, University of Iowa Hospitals and Clinics , 200 Hawkins Dr., Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin S","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Emergency Medicine, Mayo Clinic School of Medicine and Science, Mayo Clinic , 200 1st St SW, Rochester, MN 55905 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie J","family":"Harding","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Wesley Medical Center , 550 N Hillside St, Wichita, KS 67214 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giles","family":"Slocum","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Emergency Medicine, Rush University Medical Center , 1620 W Harrison St, Chicago, IL 60612 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Duquesne University School of Pharmacy , 600 Forbes Ave, Pittsburgh, PA 15282 ,","place":["USA"]},{"name":"University of Pittsburgh Medical Center- Mercy Hospital , 1400 Locust St, Pittsburgh, PA 15219 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Zepeski","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Pharmacy, University of Iowa Hospitals and Clinics , 200 Hawkins Dr., Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey","family":"Rewitzer","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Methodist Hospital, St. Louis Park , MN 55426 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin T","family":"Howington","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy , 789 S Limestone, Lexington, KY 40508 ,","place":["USA"]},{"name":"Department of Pharmacy, University of Kentucky HealthCare , 1000 S Limestone, Lexington, KY 40536 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7698-477X","authenticated-orcid":false,"given":"Matt","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Cleveland Clinic , 9500 Euclid Ave, Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Dawson","sequence":"additional","affiliation":[{"name":"Denver Health Medical Center , 777 Bannock St, Denver, CO 80204 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cierra N","family":"Treu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, New York-Presbyterian Brooklyn Methodist Hospital , 506 6th St, Brooklyn, NY 11215 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Park Nicollet, Methodist Hospital , 6500 Excelsior Blvd, St Louis Park, MN 55426 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandy","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Kentucky HealthCare , 1000 S Limestone, Lexington, KY 40536 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Flack","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Indiana University Health Methodist Hospital , 1701 N Senate Ave, Indianapolis, IN 46202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blake","family":"Porter","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Vermont Medical Center , 111 Colchester, Burlington, VT 05401 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preeyaporn","family":"Sarangarm","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of New Mexico Hospital , 2211 Lomas Blvd NE, Albuquerque, NM 87106 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia E","family":"Mattson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Emergency Medicine, Mayo Clinic School of Medicine and Science, Mayo Clinic , 200 1st St SW, Rochester, MN 55905 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abby","family":"Bailey","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy , 789 S Limestone, Lexington, KY 40508 ,","place":["USA"]},{"name":"Department of Pharmacy, University of Kentucky HealthCare , 1000 S Limestone, Lexington, KY 40536 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Administration, Rutgers Ernest Mario College of Pharmacy , 160 Frelinghuysen Rd, Piscataway, NJ 08854 ,","place":["USA"]},{"name":"Department of Pharmacy, Robert Wood Johnson University Hospital-New Brunswick , 1 Robert Wood Johnson Pl, New Brunswick, NJ 08901 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7048-8086","authenticated-orcid":false,"given":"David A","family":"Talan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Division of Infectious Diseases, Olive View-UCLA Medical Center , 14445 Olive View Dr, Sylmar, CA 91342 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"2024102107485138700_dkae070-B1","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1093\/cid\/ciq257","article-title":"International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases","volume":"52","author":"Gupta","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2024102107485138700_dkae070-B2","doi-asserted-by":"crossref","first-page":"e12694","DOI":"10.1002\/emp2.12694","article-title":"Descriptive epidemiology and outcomes of emergency department visits with complicated urinary tract infections in the United States, 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