***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: Abstract Urinary tract infections ( UTI ) can cause acute morbidity and may result in severe problems , including hypertension and reduced renal function . Diagnosis of UTI is extremely important since prompt treatment may prevent damage . In the present study we compared the efficacy of oral cefixime to initial intramuscular ceftizoxime followed by cefixime for the treatment of UTI in children . Fifty-four children were studied . They were r and omized to receive either oral cefixime 8 mg/kg/day for 10 days or initial intramuscular ceftizoxime ( Cefızox ) 50 mg/kg twice a day for 2 days followed by oral cefixime for 8 days . Treatment groups were comparable regarding age , sex , clinical , and laboratory findings . Escherichia coli was isolated from 80 % of patients . Repeat urine cultures were sterile within 24 hours in all children . Cure rates were comparable in both groups ( 92 % vs 86 % at the end of treatment ) . No serious adverse effects were observed . We concluded that oral cefixime is a safe and effective alternative treatment Background . The st and ard recommendation for treatment of young , febrile children with urinary tract infection has been hospitalization for intravenous antimicrobials . The availability of potent , oral , third-generation cephalosporins as well as interest in cost containment and avoidance of nosocomial risks prompted evaluation of the safety and efficacy of outpatient therapy . Methods . In a multicenter , r and omized clinical trial , we evaluated the efficacy of oral versus initial intravenous therapy in 306 children 1 to 24 months old with fever and urinary tract infection , in terms of short-term clinical outcomes ( sterilization of the urine and defervescence ) and long-term morbidity ( incidence of reinfection and incidence and extent of renal scarring documented at 6 months by99mTc-dimercaptosuccinic acid renal scans ) . Children received either oral cefixime for 14 days ( double dose on day 1 ) or initial intravenous cefotaxime for 3 days followed by oral cefixime for 11 days . Results . Treatment groups were comparable regarding demographic , clinical , and laboratory characteristics . Bacteremia was present in 3.4 % of children treated orally and 5.3 % of children treated intravenously . Of the short-term outcomes , 1 ) repeat urine cultures were sterile within 24 hours in all children , and 2 ) mean time to defervescence was 25 and 24 hours for children treated orally and intravenously , respectively . Of the long-term outcomes , 1 ) symptomatic reinfections occurred in 4.6 % of children treated orally and 7.2 % of children treated intravenously , 2 ) renal scarring at 6 months was noted in 9.8 % children treated orally versus 7.2 % of children treated intravenously , and 3 ) mean extent of scarring was ∼8 % in both treatment groups . Mean costs were at least twofold higher for children treated intravenously ( $ 3577 vs $ 1473 ) compared with those treated orally . Conclusions . Oral cefixime can be recommended as a safe and effective treatment for children with fever and urinary tract infection . Use of cefixime will result in substantial reductions of health care expenditures The efficacy of oral ciprofloxacin was compared with that of parenteral aminoglycoside for therapy of complicated urinary tract infection in a prospect i ve r and omized trial . The setting was a chronic-care Veterans Administration facility in which long-term bladder catheterization and resistant bacteria were common . Sixty-five consecutive patients were stratified for presence and type of bladder catheter , the presence of Providencia and Pseudomonas aeruginosa organisms versus other urinary pathogens , and renal dysfunction . A pharmacokinetic study of ciprofloxacin concentrations in serum and urine was performed with selected patients . Urinary catheters were present in 94 % . All patients were symptomatic , and 58.5 % had fever . Ciprofloxacin , 500 mg every 12 h orally , was compared with parenteral aminoglycoside for 7 to 10 days . Clinical response , defined by resolution of symptoms and fever at 5 to 9 days posttherapy ( short-term ) and 28 to 30 days posttherapy ( long-term ) , was essentially identical for both treatment groups . Bacteriologic response , defined by sterile urine cultures , showed that ciprofloxacin was significantly more efficacious ( P = 0.0005 ) than aminoglycoside at 5 to 9 days posttherapy . However , by 28 to 30 days , the response rate was essentially identical . Emergence of resistance to the study antibiotic was seen in 62 and 70 % of those who did not show a bacteriological response and were receiving ciprofloxacin and aminoglycosides , respectively . Concentrations of ciprofloxacin and aminoglycoside in the urine substantially exceeded the MIC for the urinary pathogens isolated , although these concentrations did not correlate with short-term bacteriologic response for either antibiotic . Ciprofloxacin was efficacious in complicated urinary tract infection  compared with the current st and ard of parenteral aminoglycoside among catheterized patients with relatively resistant bacteria Seventy-one adult patients with 72 infections were treated , by r and om selection , with intravenous/oral ciprofloxacin or intravenously administered ceftazidime .  Twenty-seven additional patients with 29 infections who were not appropriate for r and om assignment were treated in an open study with intravenously administered ciprofloxacin only ; the latter infections were generally more serious or were caused by ceftazidime-resistant organisms . The most common doses were ciprofloxacin , 200 mg intravenously and 500 mg orally every 12 hours and ceftazidime , 1 to 2 g intravenously every eight to 12 hours . Forty-seven ciprofloxacin-treated infections and 31 ceftazidime-treated infections were evaluable for determination of efficacy . Infections included lower respiratory tract ( 21 infections ) , urinary ( 37 infections ) , skin/soft tissue ( 14 infections ) , bacteremia/endocarditis ( four infections ) , colitis ( one infection ) , and mastoiditis ( one infection ) . Median minimal inhibitory concentrations of ciprofloxacin and ceftazidime were , respectively : for Enterobacteriaceae , Haemophilus influenzae , and Branhamella catarrhalis , no more than 0.06 and no more than 0.25 micrograms/ml ; for Pseudomonas aeruginosa , 0.25 and 4 micrograms/ml ; for Enterococcus faecalis , 1 and more than 32 micrograms/ml ; and for Staphylococcus aureus , 0.25 and 8 micrograms/ml . Ciprofloxacin , 200 mg intravenously , yielded mean serum concentrations 0.5 and eight hours post-intravenous infusion of 2.3 and 0.7 micrograms/ml , respectively . Satisfactory clinical responses were achieved in 17 ( 81 percent ) of 21 patients with intravenous/oral ciprofloxacin , 22 ( 71 percent ) of 31 patients with ceftazidime , and 20 ( 77 percent ) of 26 patients with intravenous ciprofloxacin . The most common treatment failures occurred in complicated skin/soft-tissue infections treated with intravenous/oral ciprofloxacin , complicated urinary tract infections treated with ceftazidime , and necrotizing P. aeruginosa pneumonia treated with intravenous ciprofloxacin ; the pneumonia patients all had respiratory failure and had been previously unresponsive to treatment with other appropriate drugs . Serious adverse reactions were observed in three patients , seizures with intravenous ciprofloxacin in two patients , and Clostridium difficile diarrhea with ceftazidime in one patient . We conclude that sequential intravenous/oral ciprofloxacin and ceftazidime were comparable in efficacy and safety ; the ability to change from intravenous to oral therapy is a major convenience . Intravenous ciprofloxacin was useful for more serious infections , often caused by ceftazidime-resistant organisms OBJECTIVES To compare the sequential therapy with levofloxacin with a st and ard treatment in the management of  urosepsis .  MATERIAL S AND METHODS It was a multicenter , r and omized , open label , pilot trial in community acquired urosepsis carried out in 7 hospitals .  Levofloxacin administered 500 mg twice a day intravenously and then orally was compared to piperacillin/tazobactam 4 g/0.5 g three times a day , both in combination with amikacin 7.5 mg/Kg twice a day , for a maximum of 14 days . Amikacin could be suspended between day 3 - 7 . RESULTS Both treatments were efficacious and well tolerated in the 47 enrolled patients , even tough the time to clinical stability was shorter in the levofloxacin treated patients ( 3.9 vs. 4.9 days ) . In the levofloxacin group the sequential therapy was performed in 19 ( 82.6 % ) cases , after 4.8 + /- 1.7 days of parenteral administration ( 100 % in the per- protocol population after 5.1 + /- 1.9 days ) . CONCLUSIONS The implementation of the sequential therapy in the levofloxacin group allowed an early hospital discharge in patients with urosepsis and a cost saving in the hospital perspective Abstract . The aim of this study was to compare , in children with acute pyelonephritis , the efficacy of 7 days ’ ( group A ) and 3 days ’ ( group B ) intravenous antibiotics , both followed by an oral treatment . Children were r and omized after 3 days of intravenous treatment . Technetium-99 m dimercaptosuccinic acid ( DMSA ) scintigraphy was performed within the first days after admission and repeated 6 months later . Total or partial persistence of renal abnormalities on the 6-month DMSA scintigraphy was used as the endpoint of the study . Among the 92 children included in the study , 87 were followed for at least 6 months ( 43 in group A and 44 in group B ) and were eligible for analysis .  Late DMSA was abnormal in 9 kidneys of group A and 12 kidneys of group B , representing respectively 24 % and 44 % of kidneys with abnormalities on the initial DMSA ( difference statistically not significant ) . When the patients were stratified according to the delay of treatment , the percentage of patients with sequelae in group A was comparable , whether the delay was less or more than 1 week . In group B , the percentage of patients with sequelae was significantly higher ( P<0.01 ) when the delay was more than 1 week OBJECTIVES To investigate the effects of an intravenous injection of tobramycin ( T ) in female patients with acute uncomplicated pyelonephritis treated with ciprofloxacin ( CIP ) ( 500 mg bid per os ) . METHODS It was a r and omized , multicenter , double-blind study conducted in six departments of emergency medicine . The main exclusion criteria were : previous history of urinary tract malformation of lithiasis , a recent urological procedure , pregnancy , diabetes mellitus , immunodepression , or severe sepsis . The primary criteria for evaluation were : the percentage and rate of clinical recovery , as well as bacteriological efficacy . RESULTS 118 women were enrolled , 60 in the tobramycin group and 58 in the placebo group .  E. coli was the most commonly isolated organism ; all organisms were susceptible to ciprofloxacin and tobramycin . Two women in the CIP + T group and four women in the CIP + P group failed to respond clinical ly . The recovery rate was similar in the two groups ( 96 and 93 % respectively ) . CONCLUSION Administration of a dose of tobramycin did not demonstrate its clinical benefit in treatment of acute uncomplicated pyelonephritis treated by oral ciprofloxacin The efficacy and toxicity of sequential intravenous and oral ciprofloxacin therapy was compared with intravenously administered ceftazidime in a prospect i ve , r and omized , controlled , non-blinded trial . Thirty-two patients ( 16 patients receiving ciprofloxacin and 16 patients receiving ceftazidime ) with 38 infections caused by susceptible Pseudomonas aeruginosa , enteric gram-negative rods , Salmonella group B , Serratia marcescens , Pseudomonas cepacia , and Xanthomonas maltophilia at various sites were evaluable for determination of efficacy . Length of therapy varied from seven to 25 days . Concomitant antimicrobials included intravenously administered beta-lactams for gram-positive organisms , intravenous/oral metronidazole and clindamycin for anaer 
    Output:
    
There was a variety of short-term and long-term outcomes , but no pooled outcomes showed significant differences .
There is no evidence suggesting that oral antibiotic therapy is less effective for treatment of severe UTI than parenteral or initial parenteral therapy .
The results of this review suggest that the mode of application does not determine therapeutic success