First-generation cephalosporins for the treatment of complicated upper urinary tract infection in adults: A systematic literature review

International Journal of Infectious DiseasesDíaz-Brochero C, Valderrama-Rios MC, Nocua-Báez LC, et al. | January 11, 2022


This systematic review was conducted to assess the efficacy as well as the safety of first-generation cephalosporins for community-acquired complicated upper urinary tract infection in adults needing hospital care. Findings indicate that a potential therapy may be afforded by first-generation cephalosporins in this setting, nevertheless it should be considered the low quality of evidence for examined outcomes, due to limitations of risk of bias and imprecision.

  • This is an analysis of seven randomized clinical trials.

  • Comparisons of first-generation cephalosporins with other antimicrobials showed no statistically significant differences in the outcomes of clinical cure, length of hospital stay, and reinfection.

  • The first-generation cephalosporin group showed a lower probability of microbiological cure and a higher probability of relapse in 3 of 7 studies and in 2 of 5 studies, respectively.

  • No serious adverse effects occurred.

  • These observations call for comparative studies wherein the benefits and harms of these antibiotics are assessed.

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