Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
1999-7-19
pubmed:abstractText
The outcome of three types of management for patients with acute pyelonephritis, in an emergency department is assessed. This was carried out by a prospective enrolment of patients with acute pyelonephritis. Through a decisional algorithm, doctors were encouraged to discharge female patients under 60 years with acute uncomplicated pyelonephritis, either directly from the emergency ward or after a short stay in the observation unit. All received a single intravenous dose of pefloxacin, after urine and blood cultures were obtained; before discharge a normal ultrasonography of the abdomen and the pelvis was required. Conversely, hospitalization was advised for patients who did not fit the criteria of uncomplicated pyelonephritis. Only females with positive urine cultures qualified. Of 83 patients enrolled, 70 were females with positive urine cultures, 60 of whom had uncomplicated pyelonephritis. At 3 weeks, two of 70 patients were lost to follow-up. In the remaining 68, favourable outcome was observed in 98% of 48 patients discharged from the observation unit (95% CI: [94%; 100%]), 90% of 10 discharged from the emergency ward (95% CI: [73%; 100%]) and 70% of 10 hospitalized (95% CI: [50%; 93%]). A decisional algorithm was useful in determining that over 85% of women who present to our emergency department with pyelonephritis have an uncomplicated form and may be safely treated as outpatients, if necessary after a brief stay in the observation unit. Prospective controlled trials are needed to determine duration of antimicrobial therapy, length of follow-up and finally, to compare tolerance and cost-effectiveness of outpatient vs. inpatient care of acute uncomplicated pyelonephritis.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0969-9546
pubmed:author
pubmed:issnType
Print
pubmed:volume
6
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
15-20
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:10340729-Acute Disease, pubmed-meshheading:10340729-Adolescent, pubmed-meshheading:10340729-Adult, pubmed-meshheading:10340729-Algorithms, pubmed-meshheading:10340729-Ambulatory Care, pubmed-meshheading:10340729-Anti-Infective Agents, pubmed-meshheading:10340729-Bacterial Infections, pubmed-meshheading:10340729-Confidence Intervals, pubmed-meshheading:10340729-Decision Making, pubmed-meshheading:10340729-Emergency Service, Hospital, pubmed-meshheading:10340729-Feasibility Studies, pubmed-meshheading:10340729-Female, pubmed-meshheading:10340729-France, pubmed-meshheading:10340729-Humans, pubmed-meshheading:10340729-Injections, Intravenous, pubmed-meshheading:10340729-Length of Stay, pubmed-meshheading:10340729-Middle Aged, pubmed-meshheading:10340729-Observation, pubmed-meshheading:10340729-Pefloxacin, pubmed-meshheading:10340729-Pregnancy, pubmed-meshheading:10340729-Pregnancy Complications, Infectious, pubmed-meshheading:10340729-Prognosis, pubmed-meshheading:10340729-Prospective Studies, pubmed-meshheading:10340729-Pyelonephritis, pubmed-meshheading:10340729-Software, pubmed-meshheading:10340729-Treatment Outcome
pubmed:year
1999
pubmed:articleTitle
Relevance in the emergency department of a decisional algorithm for outpatient care of women with acute pyelonephritis.
pubmed:affiliation
Service des Urgences, Hôpital Lariboisière, Paris, France.
pubmed:publicationType
Journal Article