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In reply

We appreciate the wise comments of Dr Kunin on my and my colleagues' article on prediction of mortality and failure of treatment in adults with acute pyelonephritis.¹ Dr Kunin suggests that a more appropriate title for our article would have been "The Urosepsis Syndrome in Adults With Complicated Urinary Tract Infections." We agree with Dr Kunin that proper nomenclature is important to allow proper comparisons to be made. One of the reasons we performed our study was the lack of data, especially in men, on the ability to predict mortality and failure of treatment due to resistant pathogens in patients with the most severe forms of urinary tract infections (UTIs). Indeed, as we state in the introduction of our study,¹ numerous studies have focused on antimicrobial resistance of bacteria that cause UTIs in general, without attempts to differentiate the most severe from the most benign (namely, cystitis) forms . . . [Full Text of this Article]

Angelos V. Pefanis, MD
Athens, Greece

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