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International Journal of Clinical Pharmacy

, Volume 40, Issue 1, pp 143–149 | Cite as

Retrospective review of ceftriaxone versus levofloxacin for treatment of E. coli urinary tract infections

  • Samantha S. Wang
  • Patrick D. RatliffEmail author
  • William R. Judd
Research Article

Abstract

Background Urinary tract infections (UTIs) are among the most common bacterial infections. Options for initial treatment of pyelonephritis or UTI requiring hospitalization include levofloxacin (LVF) or extended-spectrum cephalosporins. Globally, uropathogenic Escherichia coli resistance rates to fluoroquinolones have increased in recent years. Objective To compare clinical outcomes of patients receiving ceftriaxone (CTX) to those who received LVF empirically for the treatment of E. coli UTI. Setting 433-bed community hospital in Lexington, KY. Methods Retrospective, single center, cohort study of adults with a urine culture positive for E. coli who received either IV LVF or CTX empirically for the treatment of UTI. Main outcome measure The primary outcome was hospital length of stay. Secondary outcomes include time to susceptible therapy (TsT), hospital cost, and susceptibility to empiric therapy. Results There was no statistically significant difference in LOS or hospital cost. Subgroup analysis compared patients that received concordant CTX treatment and patients that received discordant LVF treatment. Patients that received concordant CTX treatment had a nonsignificant shorter median LOS (4.16 vs. 6.34 days). Median hospital cost was lower ($4345 vs. $8462, p = 0.004) and median TsT was shorter (5.83 vs. 64.46 h, p < 0.001) in the concordant CTX group. Conclusion Choice of empiric antibiotic therapy should be based on local antibiogram data. For patients with UTI requiring hospitalization, CTX seems to be an effective empiric therapy for most patients. More data is required to examine the effectiveness of local and source specific antibiograms on clinical outcomes when guiding treatment of patients with UTI.

Keywords

Antibiogram Beta lactam Ceftriaxone Fluoroquinolone Levofloxacin Resistance United States Urinary tract infections 

Notes

Acknowledgements

None.

Funding

This research was not funded.

Conflicts of interest

All authors have nothing to disclose and no conflicts of interest.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  • Samantha S. Wang
    • 1
  • Patrick D. Ratliff
    • 2
    Email author
  • William R. Judd
    • 2
  1. 1.Department of Pharmacy ServicesDuke University HospitalDurhamUSA
  2. 2.Department of Pharmacy ServicesSaint Joseph HospitalLexingtonUSA

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