Table 2.
Effect of mecillinam and mecillinam in combination with other beta-lactams for the treatment of pyelonephritis with and without bacteremia
| Mecillinam
| ||||||
|---|---|---|---|---|---|---|
| Reference | Without predisposing factors (AUP)
|
With predisposing factors
|
All pyelonephritis
|
|||
| Clinical success | Bacteriological success (without relapse/reinfections) | Clinical success | Bacteriological success (without relapse/reinfections) | Clinical success | Bacteriological success (without relapse/reinfections) | |
| Ode et al39 | 12/14 | 11/13a | 5/6 | 1/5b | 17/20 | 12/18b,b |
| Trollfors et al38 | Not possible to determine | 15/25 | 18/23c | |||
| Jansåker et al40 | 6/6 | 5/6 | – | – | 6/6 | 5/6 |
| Total | 18/20 (90%) | 16/19 (84%) | 5/6 (83%) | 1/5 (20%) | 38/51 (75%) | 35/47 (74%) |
|
Mecillinam in combination with other beta-lactams | ||||||
| Reference | Without predisposing factors (AUP) (overall successd) | With predisposing factors (overall successd) |
All acute pyelonephritis
|
|||
| Clinical success | Bacteriological success (without relapse/reinfections) | |||||
|
| ||||||
| Rotstein and Farrar37 | Not possible to determine | Not possible to determine | 16/20 | 20/20 | ||
| King et al35 | Not possible to determine | Not possible to determine | 26/28 | 21/31 | ||
| Eriksson et al31 | 11/20 | 4/7 | 25/27 | 15/27 | ||
| Jernelius et al34,e | 13/16 | 1/13 | 28/29 | 20/29 | ||
| Cronberg et al29 | Not possible to determine | Not possible to determine | 57/60 | 41/60 | ||
| Total | 24/36 (67%) | 5/20 (25%) | 152/164 (93%) | 117/167 (70%) | ||
Notes:
a
Resistant E. coli was not evaluable because change in therapy.
b
Resistant K. pneumoniae was not evaluable because change in therapy.
c
Two dropouts, three asymptomatic bacteriuria (different strains), and two bacteriuria with symptoms of LUTI.
d
Defined as both clinical success and bacteriological success, without bacteriological relapse.
e
Since it was significantly inferior, the 1-week therapy was not included.
Abbreviations: AUP, acute uncomplicated pyelonephritis; K. pneumoniae, Klebsiella pneumoniae; E. coli, Escherichia coli.