Controversies in Treating Asymptomatic Bacteriuria and Urinary Tract Infection: A Case Based Review of Antibiotic Use in Renal Transplant Patients and its Impact on the Development of Resistance

This chapter provides information on the ageing immune system, an overview of infection in older people, antibiotic use in older patients, meticillin-resistant Staphylococcus aureus (MRSA), disease caused by MRSA, Clostridium difficile-associated diarrhoea, near-patient urine tests, asymptomatic bacteriuria, urinary tract infection, treatment of urinary tract infection, recurrent urinary tract infection, and varicella-zoster infection.

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Perioperative fosfomycin disodium prophylaxis against urinary tract infection in renal transplant recipients: a randomized clinical trial

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz261 ◽

2020 ◽

Vol 35 (11) ◽

pp. 1996-2003 ◽

Cited By ~ 1

Author(s):

Rodrigo Rosado-Canto ◽

Idalia Parra-Avila ◽

Javier Tejeda-Maldonado ◽

Cristopher Kauffman-Ortega ◽

Francisco T Rodriguez-Covarrubias ◽

...

Keyword(s):

Urinary Tract Infection ◽

Placebo Group ◽

Urinary Tract ◽

Renal Transplant ◽

Tract Infection ◽

Asymptomatic Bacteriuria ◽

Attractive Alternative ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

The Mean

Abstract Background Symptomatic urinary tract infection (UTI) is the most common infectious complication in renal transplant recipients (RTRs). Fosfomycin (FOS) is an attractive alternative for prophylaxis because it does not interact with immunosuppressants; although 90% is excreted unchanged in the urine, it does not require adjustment for renal function for single dose prophylaxis. Methods RTRs were recruited into this randomized, double-blind, placebo-controlled trial. Participants were randomized (1:1) to receive one 4 g dose of FOS disodium intravenously 3 h (FOS group) or placebo (placebo group) before placement and removal of a urinary catheter and before removal of a double-J ureteral stent. All participants received prophylaxis with trimethoprim/sulfamethoxazole. The main outcome was a comparison of the mean number of symptomatic UTI and asymptomatic bacteriuria (AB) episodes per patient during a 7-week follow-up period. The study was registered at ClinicalTrials.gov, NTC03235947. Results Eighty-two participants were included (41 in the FOS group and 41 in placebo group). The mean number of AB or symptomatic UTI episodes per patient was lower in the FOS group [intention-to-treat (ITT) 0.29 versus 0.60, P = 0.04]. The incidence of symptomatic UTI was lower in the FOS group (ITT, 7.3% versus 36.6%, P = 0.001), and there was no difference in the incidence of AB between both groups. The incidence of adverse events was similar in both groups. Conclusions FOS addition is an effective and safe strategy to reduce the number of symptomatic UTIs during the first 7 weeks after renal transplant.

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Importance of Urinary Tract Infection to Antibiotic Use Among Hospitalized Patients

Infection Control and Hospital Epidemiology ◽

10.1086/593951 ◽

2009 ◽

Vol 30 (2) ◽

pp. 193-195 ◽

Cited By ~ 30

Author(s):

Tejal Gandhi ◽

Scott A. Flanders ◽

Erica Markovitz ◽

Sanjay Saint ◽

Daniel R. Kaul

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Broad Spectrum ◽

Urine Culture ◽

Asymptomatic Bacteriuria ◽

Antibiotic Use ◽

Hospitalized Patients ◽

Broad Spectrum Antibiotics

Many patients with asymptomatic bacteriuria receive extended courses of broad-spectrum antibiotics. Antibiotic use was analyzed in patients admitted to the hospital with urinary tract infection. Strategies to optimize antibiotic use for such patients are discussed and include implementing a process whereby a urine culture is automatically performed if a urinalysis result suggests infection.

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