Pyelonephritis Acute
Conditions
Brief summary
Acute pyelonephritis (APN) corresponds to infections of the renal parenchyma. The annual incidence of these infections is estimated at 4-6 million cases in France, with 60 to 90% of patients managed in general city medicine. The ceftriaxone, parenteral third-generation cephalosporin (C3G), occupies an important place in the antibiotic treatment of these infections: this is the recommended probabilistic treatment, and in some situations the treatment can be continued in its entirety via a Ceftriaxone monotherapy. The aim of the last antibiotic plan is to avoid the use of antibiotic therapies with a high selection capacity (cephalosporins, penicillins, fluoroquinolones, etc.) and thus reduce the incidence and prolongation over time of the digestive carriage of multi-resistant bacteria . To date, there have been few studies evaluating the impact of ceftriaxone on the emergence of multi-resistant bacteria on an individual scale, with rather heterogeneous results (13-86% C3G resistance). Thus, before considering randomized studies comparing the ecological impact of different molecules or therapeutic regimens in the treatment of ANP, it is necessary to have a precise and rigorous evaluation of the ecological impact of the molecule reference in this indication. The investigators propose a study to evaluate the impact on the digestive flora at 1 month of a ceftriaxone antibiotic therapy (7 days) in the management of acute pyelonephritis in women.
Interventions
DRUGCeftriaxone
ceftriaxone (1g intravenous or 1g/35mL intramuscular) will be given to patients during 7 days
Sponsors
Centre Hospitalier Universitaire de Nice
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Female * Over 18 years old * Admitted to the emergency department with a diagnosis of PNA (simple or at risk of complications, without signs of seriousness)
Exclusion criteria
* Hypersensitivity to ceftriaxone, to another cephalosporin or to any of the excipients * A history of severe hypersensitivity (eg anaphylactic reaction) to another class of antibacterial agent in the beta-lactam family (penicillins, monobatams and carbapenems) * Severe pyelonephritis, including obstructive APN * Pyelonephritis in patients with a urinary catheter * Antibiotic treatment in the previous 6 months * Chronic dialysis patient * Patient with hepatic impairment * Pregnancy or breast-feeding in progress
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Emergence of ceftriaxone-resistant Enterobacteriaceae | at 28 days | The emergence of ceftriaxone-resistant Enterobacteriaceae at 28 days after cessation of treatment on rectal swab. |
Countries
France
Outcome results
None listed