***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Acute pyelonephritis remains a frequent complication of pregnancy . Prevention of the potential complications of this disease requires aggressive in-hospital management . However , the high frequency of positive outpatient cultures following discharge has cast doubt on the adequacy of in-hospital care and , at the same time , has concentrated attention on follow-up care . In a r and omized , prospect i ve study , we evaluated the effects of in-hospital management and outpatient nitrofurantoin  on subsequent urine cultures . The overall frequency of positive cultures following discharge from the hospital was 38 % . However , appropriate antibiotic selection , a negative follow-up in-hospital culture and nitrofurantoin suppression reduced the rate to 8 % ( P less than .01 ) . Nitrofurantoin did not reduce the rate of positive cultures if antibiotic selection was inappropriate or if the in-hospital follow-up culture was positive . These results suggest that more aggressive management of acute pyelonephritis in pregnancy may be indicated and that suppressive therapy can not compensate for inappropriate in-hospital management Today , it is widely accepted that a short-course or single-dose treatment with antimicrobial agents in pregnancy is the optimal therapy to minimize the risk of toxicity both for the mother and the fetus . A r and omized trial comparing single-dose ( 3 g ) treatment with fosfomycin trometamol ( FT ) versus pipemidic acid ( 200-gram doses b.i.d . for 7 days ) in bacteriuric pregnant women is presented . The preliminary results show that single-dose FT has the same cure effect as conventional therapy with pipemidic acid A total of 120 patients , including 53 pregnant women with significant bacteriuria , received 163 7-day courses of oral antimicrobial agents allocated in a r and omised manner . The cure rates after 6 weeks ' follow-up ranged from 73 % to 86 % , and there was no statistical difference between preparations of ampicillin , carbenicillin indanyl easter , and 2 different formulations of nifuratel .  Side-effects occurred in 30 % to 40 % of the courses of penicillin drugs , but in under 15 % of the course of nifuratel . It is concluded that the new oral preparation of carbenicillin is a useful addition to the list of antimicrobial agents which are effective in the treatment of urinary infections in domiciliary patients . Furthermore , nifuratel has been confirmed as a highly active non-toxic drug which is valuable in the treatment of urinary infections Summary The clinical and bacteriological efficacy and adverse reactions of ofloxacin vs trimethoprim-sulphamethoxazole were investigated in a double-blind , r and omised study in 250 female patients ( 125 in each group ) with acute , uncomplicated lower urinary tract infections . The dosages of ofloxacin and trimethoprim-sulphamethoxazole were 100 mg and 160 mg + 800 mg twice daily , respectively . The duration of therapy was 3 days . 81 % of the patients had significant bacteriuria . Escherichia coli was isolated in 76 % and Staphylococcus saprophyticus in 11 % of the infections . The bacteriological elimination , clinical cure and improvement rates of the evaluable patients on ofloxacin treatment were 92 and 95 % , respectively . The corresponding figures on trimethoprim-sulphamethoxazole therapy were 88 and 90 % . Adverse reactions were clinical ly unimportant , and none of the patients had to stop treatment . Mild and transient side effects , mainly from the gastrointestinal tract , central nervous system and skin , were reported by 19 and 22 % of the patients in the ofloxacin and trimethoprim-sulphamethoxazole groups , respectively . None of the differences in clinical and bacteriological efficacy and side effects of ofloxacin vs trimethoprim-sulphamethoxazole were statistically significant . Ofloxacin appears to be an appropriate antibiotic for short term therapy of acute , uncomplicated , lower urinary , tract infections , comparing favourably with trimethoprim-sulphamethoxazole treatment in this study 
    Output:
    
In most of the comparisons there were no significant differences between the treatments under study with regard to cure rates , recurrent infection , incidence of preterm delivery , admission to neonatal intensive care unit , need for change of antibiotic and incidence of prolonged pyrexia .
Although antibiotic treatment is effective for the cure of urinary tract infections , there are insufficient data to recommend any specific drug regimen for treatment of symptomatic urinary tract infections during pregnancy .
All the antibiotics studied were shown to be very effective in decreasing the incidence of the different outcomes .
Complications were very rare .