The efficacy and safety of cefixime and amoxicillin/ clavulanate in the treatment of asymptomatic bacteriuria in pregnant women: a randomized, prospective, multicenter study


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The study was aimed to the evaluation of efficacy and safety of cefixime and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women. A prospective, multicenter, randomized study that included 112 pregnant women with asymptomatic bacteriuria was performed. 58 women were randomized in group 1 (cefixime [suprax solutab®] 400 mg 1 time a day, 7 days), 54 women were included in group 2 (amoxicillin/clavulanate [amoksiklav®] 625 mg 3 times a day, 7 days). The average age of the patients in group 1 was 25,2±6,6; in group 2 - 26,6±5,8 years. Physical examination, evaluation of complaints, collection of data on adverse reactions, and bacteriological analysis of urine were performed after enrollment in the study at visit 2 (day 10±1) and 3 (day 35±2). Comparable effectiveness of cefixime and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women was found. Eradication of the pathogen and sustained bacteriological response were observed in 94,8 and 92,7% of women treated with cefixime, and in 98,2 and 92,5 % of women treated with amoxicillin/clavulanate, respectively (P> 0,05). At the same time, the use of amoxicillin/clavulanate compared with cefixime significantly higher was followed by the development of adverse reactions (13% and 1,7; respectively; P = 0,02). Seven-day courses of cefixime at a dose 400 mg 1 time a day and amoxicillin/clavulanate at a dose of 625 mg 3 times a day are high-effective treatment regimens for asymptomatic bacteriuria in pregnant women in Russia. The use of amoxicillin/ clavulanate is significantly more often accompanied by the development of adverse reactions compared with cefixime.

Full Text

Restricted Access

References

  1. Nicolle L.E. et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin. Infect. Dis. 2005;40(5):643-654.
  2. Nicolle L.E. Asymptomatic bacteriuria: when to screen and when to treat. Infect. Dis. Clin. North Am. 2003;17(2):367-394.
  3. Sheiner E., Mazor-Drey E., Levy A. Asymptomatic bacteriuria during pregnancy. J Matern. Fetal. Neonatal. Med. 2009;22(5): 423-427.
  4. Quiroga-Feuchter G. et al. Asymptomatic bacteriuria among pregnant women. An underestimated threat. Rev. Med. Inst. Mex. Seguro Soc. 2007;45(2):169—172.
  5. Mignini L. et al. Accuracy of diagnostic tests to detect asymptomatic bacteriuria during pregnancy. Obstet. Gynecol. 2009;113(2 Pt 1): 346-352.
  6. Brumfitt W. The effects of bacteriuria in pregnancy on maternal and fetal health. Kidney Int. 1975;4(Suppl.):S113-119.
  7. Imade P.E. et al. Asymptomatic bacteriuria among pregnant women. N. Am. J Med. Sci. 2(6):263-266.
  8. Smaill F. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst. Rev. 2001(2): p. CD000490.
  9. Mittendorf R., Williams M.A., Kass E.H. Prevention of preterm delivery and low birth weight associated with asymptomatic bacteriuria. Clin. Infect. Dis. 1992;14(4):927-932.
  10. Keren R., Chan E. A meta-analysis of randomized, controlled trials comparing short- and long-course antibiotic therapy for urinary tract infections in children. Pediatrics. 2002;109(5):E70-0.
  11. Estebanez A. et al. Fosfomycin in a single dose versus a 7-day course of amoxicillin-clavulanate for the treatment of asymptomatic bacteriuria during pregnancy. Eur. J Clin. Microbiol. Infect. Dis. 2009;28(12):1457-1464.
  12. Darze O.I., Barroso U., Lordelo M. Clinical predictors of asymptomatic bacteriuria during pregnancy. Rev. Bras. Ginecol. Obstet. 2011;33(8):196-200.
  13. Awonuga D.O. et al. Asymptomatic bacteriuria in pregnancy: evaluation of reagent strips in comparison to microbiological culture. Afr. J Med. Med. Sci. 2011;40(4):377-383.
  14. Celen S. et al. Asymptomatic bacteriuria and antibacterial susceptibility patterns in an obstetric population. ISRN Obstet. Gynecol. 2011;2011: 721872.
  15. McNair R.D., et al. Evaluation of the centrifuged and Gram-stained smear, urinalysis, and reagent strip testing to detect asymptomatic bacteriuria in obstetric patients. Am. J Obstet. Gynecol. 2000;182(5):1076-1079.
  16. Lumbiganon P. et al. One-day compared with 7-day nitrofurantoin for asymptomatic bacteriuria in pregnancy: a randomized controlled trial. Obstet. Gynecol. 2009;113(2 Pt 1):339-345.
  17. Reddy J., Campbell A. Bacteriuria in pregnancy. Aust N Z J Obstet Gynaecol. 1985;25(3):176-178.
  18. McIsaac W. et al. Screening for asymptomatic bacteriuria in pregnancy. J Obstet. Gynaecol. Can. 2005;27(1):20-24.
  19. Colgan R. et al. Asymptomatic bacteriuria in adults. Am. Fam. Physician. 2006;74(6):985-990.
  20. Stamatiou K. et al. Study on the efficacy of cefaclor for the treatment of asymptomatic bacteriuria and lower urinary tract infections in pregnant women with a history of hypersensitivity to penicillin. Clin. Exp. Obstet. Gynecol. 2007;34(2):85-87.
  21. Robertson J.G., Livingstone J.R., Isdale M.H. The managment and complications of asymptomatic bacteriuria in pregnancy. Report of a study on 8,275 patients. J Obstet. Gynaecol. Br. Commonw. 1968;75(1):59-65.
  22. Bayrak O. et al. Is single-dose fosfomycin trometamol a good alternative for asymptomatic bacteriuria in the second trimesterof pregnancy? Int. Urogynecol. J Pelvic. Floor. Dysfunct. 2007;18(5):525—529.
  23. Bint A. et al. A comparative trial of pivmecillinam and ampicillin in bacteriuria of pregnancy. Infection. 1979;7(6):290-293.
  24. Campbell-Brown M. et al. Is screening for bacteriuria in pregnancy worth while? Br. Med. J (Clin Res Ed). 1987;294(6587):1579-1582.
  25. Rafal'skii V.V., Divgan E.V., Derevitskii A.V. Cefixim: clinical pharmacology and role in therapy of urogenital infections. Urologiia. 2011(2):63—66.
  26. Naber K.G. et al. Surveillance study in Europe and Brazil on clinical aspects and Antimicrobial Resistance Epidemiology in Females with Cystitis (ARESC): implications for empiric therapy. Eur. Urol. 2008;54(5):1164—1175.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies