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  • Title: Acute pyelonephritis in pregnancy: a prospective study of oral versus intravenous antibiotic therapy.
    Author: Angel JL, O'Brien WF, Finan MA, Morales WJ, Lake M, Knuppel RA.
    Journal: Obstet Gynecol; 1990 Jul; 76(1):28-32. PubMed ID: 2193265.
    Abstract:
    Ninety pregnant women admitted to the high-risk pregnancy unit with a diagnosis of acute pyelonephritis were randomized to receive either oral (cephalexin 500 mg every 6 hours) or intravenous (IV) (cephalothin 1 g every 6 hours) antibiotic therapy. All patients were initially hydrated with 1 L of normal saline IV over 4 hours. Neither parenteral analgesics nor antiemetics were used. Bacteremia was noted in 13 (14.4%) of the 90 patients and mandated IV therapy. There was no difference between the oral and IV groups concerning predefined criteria for successful therapy (91.4 versus 92.9% successful therapy, respectively). No characteristic available at presentation predicted bacteremia or ultimate failure of therapy. Two patients (2.2%) experienced significant complications. These data suggest that in nonbacteremic patients, oral antibiotics are both safe and effective for the treatment of acute pyelonephritis in pregnancy.
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