{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:16:43Z","timestamp":1784791003218,"version":"3.55.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The current Infectious Diseases Society of America guidelines for the treatment of acute uncomplicated pyelonephritis (AUP) advise caution when using oral beta-lactams due to concern for potentially inferior efficacy compared to fluoroquinolones (FQs) and trimethoprim-sulfamethoxazole; however, studies specifically evaluating the efficacy of oral cephalosporins (CPs) in AUP are limited.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To assess the safety and efficacy of oral CPs versus FQs for the treatment of AUP.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Design, setting and participants<\/jats:title>\n<jats:p>This is a retrospective, chart review study conducted at a single-center, tertiary care hospital.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Measurements<\/jats:title>\n<jats:p>The primary endpoint was treatment failure within 30 days, defined as a change in antibiotic or return to ED or clinic due to persistent symptoms. Secondary endpoints included adverse drug reactions (ADRs) and <jats:italic>C<\/jats:italic>. <jats:italic>difficile<\/jats:italic> infection (CDI) within 30 days.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 343 patients included in the study, treatment failure occurred in 54\/338 (16.0%) patients and was similar between oral CPs and FQs (35\/229 [15.3%] vs. 19\/109 [17.4%]). A higher percentage of treatment failures were observed for third generation (3GC) and first generation (1GC) CPs compared to second generation CPs (2GC) (3GC: 15\/65 [23.4%]; 1GC: 11\/49 [22.4%]; 2GC: 9\/115 [7.8%]). Documented ADRs were low (6\/343 [1.7%]) and no cases of CDI were documented.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Oral CPs appear to be as safe and effective as FQs for the treatment of AUP. Fewer treatment failures were noted with 2GCs as compared to 3GCs and 1GCs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0274194","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T20:12:56Z","timestamp":1662754376000},"page":"e0274194","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["A retrospective review of oral cephalosporins versus fluoroquinolones for the treatment of pyelonephritis"],"prefix":"10.1371","volume":"17","author":[{"given":"Kevin","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yorgo","family":"Zahlanie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica K.","family":"Ortwine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3765-4644","authenticated-orcid":true,"given":"Norman S.","family":"Mang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2188-9780","authenticated-orcid":true,"given":"Bonnie C.","family":"Prokesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"pone.0274194.ref001","unstructured":"Health, United States, 2016. 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