scholarly journals 17. Comparative Safety of Antibiotic Therapy for Outpatient Treatment of Uncomplicated Urinary Tract Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S9-S10
Author(s):  
Anne M Butler ◽  
Michael Durkin ◽  
Matthew R Keller ◽  
Yinjiao Ma ◽  
William Powderly ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Abdominal Pain ◽  
Urinary Tract ◽  
Skin Rash ◽  
Adverse Drug Events ◽  
Vulvovaginal Candidiasis ◽  
First Line ◽  
Research Support ◽  
Comparative Safety

Abstract Background Urinary tract infection (UTI) is one of the most common indications for outpatient antibiotic prescriptions in otherwise healthy women, yet the comparative safety of antibiotics for empirical therapy is not well established. We compared the risk of adverse drug events by antibiotic treatment regimen among premenopausal women with uncomplicated UTI. Methods Using the IBM MarketScan Commercial Database (2006–2015), we identified healthy, non-pregnant women aged 18–44 who were diagnosed with UTI and prescribed a same-day antibiotic with activity against common uropathogens. Patients were followed for outcomes with varying follow-up periods: 3 days (anaphylaxis), 14 days (acute renal failure, skin rash, urticaria/hives, nausea/vomiting, abdominal pain), 30 days (vaginitis/vulvovaginal candidiasis, non-C. difficile diarrhea) and 90 days (C. difficile diarrhea, pneumonia, tendinopathy, retinal detachment). We estimated propensity score-weighted hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards models. Results Of 1,140,602 eligible women, the distribution of antibiotic receipt was fluoroquinolones (44%), trimethoprim-sulfamethoxazole (TMP/SMX) (28%), nitrofurantoin (24%), narrow-spectrum β-Lactam / β-Lactamase inhibitor combinations (“β-Lactams”) (3%), broad-spectrum β-Lactams (1%) and amoxicillin/ampicillin (1%). Of two first-line agents, we observed higher risk of outcomes among TMP/SMX vs. nitrofurantoin initiators: acute renal failure (HR 2.46, 95% CI 1.46–4.14), skin rash (HR 2.43, 95% CI 2.13–2.77), urticaria (HR 1.35, 95% CI 1.18–1.56), nausea/vomiting (HR 1.19, 95% CI 1.10–1.29) and abdominal pain (HR 1.14, 95% CI 1.09–1.19). Compared to nitrofurantoin, non-first-line agents (fluoroquinolones, broad-, and/or narrow-spectrum β-Lactams) were associated with higher risk of acute renal failure, skin rash, nausea/vomiting, abdominal pain, vaginitis/vulvovaginal candidiasis, diarrhea (C. difficile & non-C. difficile), pneumonia and tendinopathy. Conclusion The risk of adverse drug events differs widely by antibiotic agent, with substantial differences in first-line agents. Understanding antibiotic safety is critical to prevent suboptimal antibiotic prescribing and reduce adverse events. Disclosures Margaret A. Olsen, PhD, MPH, Merck (Grant/Research Support)Pfizer (Consultant, Grant/Research Support)

scholarly journals Meprin A metalloproteases enhance renal damage and bladder inflammation after LPS challenge

2009 ◽  
Vol 296 (1) ◽  
pp. F135-F144 ◽  
Author(s):  
Renee E. Yura ◽  
S. Gaylen Bradley ◽  
Ganesan Ramesh ◽  
W. Brian Reeves ◽  
Judith S. Bond
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Urinary Tract ◽  
Nitrogen Levels ◽  
Lps Challenge ◽  
Lower Blood ◽  
Tnf Α ◽  
Meprin Metalloproteases ◽  
Membrane Bound

Meprin metalloproteases, composed of α and/or β subunits, consist of membrane-bound and secreted forms that are abundantly expressed in proximal tubules of the kidney as well as secreted into the urinary tract. Previous studies indicated that meprin metalloproteases play a role in pathological conditions such as ischemic acute renal failure and urinary tract infection. The aim of this work was to examine the role of meprins in endotoxemic acute renal failure using meprin α knockout (αKO), meprin β knockout (βKO), and wild-type (WT) mice. Differences among the responses of the genotypes were observed as early as 1 h after challenge with 2.5 mg/kg ip Escherichia coli LPS, establishing roles for meprins in the endotoxemic response. Meprin αKO mice displayed lower blood urea nitrogen levels and decreased nitric oxide levels, indicative of a decreased systemic response to LPS compared with WT and meprin βKO mice. Serum cytokine profiles showed lower levels of IL-1β and TNF–α in the meprin αKO mice within 3 h after LPS challenge and confirmed a role for meprins in the early phases of the host response. Meprin αKO mice were also hyporesponsive to LPS administered to the bladder, exhibiting significantly less bladder edema, leukocyte infiltration, and bladder permeability than WT mice. These data indicate that meprin A contributes to the renal and urogenital pathogenesis of endotoxicity.

scholarly journals A 71-year-old woman with abdominal pain and acute renal failure

2007 ◽  
Vol 177 (5) ◽  
pp. 454-455 ◽  
Author(s):  
A. Schattner ◽  
J. Kopolovic ◽  
E. Melzer ◽  
J. Rapoport
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Abdominal Pain

Ascites, abdominal pain, and acute renal failure in a middle-aged woman

2019 ◽  
Vol 15 (2) ◽  
pp. 299-302
Author(s):  
Giorgio Colombo ◽  
Ludovico Furlan ◽  
Francesco Mucci ◽  
Stefania Zannoni ◽  
Maria Carmela Andrisani ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Abdominal Pain ◽  
Middle Aged ◽  
Aged Woman ◽  
Middle Aged Woman

scholarly journals Congenital uronephropathy pattern in children

2001 ◽  
Vol 41 (5) ◽  
pp. 241
Author(s):  
Husein Alatas ◽  
Natalina Soesilawati ◽  
Bambang Madiyono
Keyword(s):  
Renal Failure ◽  
Urinary Tract Infection ◽  
Acute Renal Failure ◽  
Urinary Tract ◽  
Chronic Renal Failure ◽  
Tract Infection ◽  
Teaching Hospitals ◽  
Affecting Factors ◽  
Cross Sectional ◽  
Renal Hypoplasia

To obtain the basic data of congenital uronephropathy pattern and the affecting factors in children, we conducted a cross-sectional study at the Department of Child Health Cipto Mangunkusumo (CM) Hospital Jakarta from 1995 to 1999 and 9 teaching hospitals throughout Indonesia. During the study period 134 patients were obtained, 116 patients from the CM Hospital and 18 patients from other teaching hospitals. Most patients (48.8%) were below 1 year of age; male were affected more than female (2.4:1). The disorder was classified into two groups, i.e., congenital nephropathy and uropathy. There were 10 children with nephropathy, i.e., 4 with unilateral renal hypoplasia, 3 with polycystic kidney, and 3 with renal agenesis. In the uropathy group, 43 were with hypospadia, 22 with primary reflux vesicoureter, 18 with neurogenic bladder, and 17 with ureteropelvic junction obstruction. The complications found were urinary tract infection (71.2%), chronic renal failure (15.7%), hypertension (3.7%), and acute renal failure (1.5%). Consanguinity, familial disorders, maternal diseases, x-ray exposure and abortion efforts were found in a small proportion of patients. History of drug or herbs use in the first trimester of pregnancy was found in a large proportion of patients, mostly took analgesics (especially acetaminophen). In conclusion, uropathy disorders were much more common than congenital nephropathy. The most common complication was urinary tract infection, followed by chronic renal failure, hypertension, and acute renal failure.

Sulfadiazine-related obstructive urinary tract lithiasis: an unusual cause of acute renal failure after kidney transplantation

2005 ◽  
Vol 63 (05) ◽  
pp. 405-407 ◽  
Author(s):  
J. Guitard ◽  
N. Kamar ◽  
M. Mouzin ◽  
J.S. Borde ◽  
T. Tran-Van ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Kidney Transplantation ◽  
Urinary Tract

Acute renal failure in bilateral urinary tract tuberculosis

1998 ◽  
Vol 13 (2-3) ◽  
pp. 200-201 ◽  
Author(s):  
S. Gupta ◽  
V. Bhatnagar ◽  
D. K. Mitra ◽  
A. K. Gupta ◽  
A. Bagga ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Urinary Tract

scholarly journals Fog Juice Poisoning

2014 ◽  
Vol 14 (2) ◽  
pp. 195-197
Author(s):  
FM Mofakharul Islam ◽  
AK Saha ◽  
MA Mannan ◽  
TU Hassan ◽  
M Rahman ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Abdominal Pain ◽  
Respiratory Distress ◽  
Clear Fluid ◽  
Severe Respiratory Distress ◽  
The Poor ◽  
Upper Abdominal

A 19 yrs old male was admitted with upper abdominal pain and vomiting following ingestion of a fluid he thought to be beer. After repeated inquiry it was found that the clear fluid was “Fog Juice’’, used to produce artificial “Fog” or Smoke on the stage. After 36 hours of ingestion the patient developed severe respiratory distress & itching. Investigation reports confirmed Acute Renal Failure & Hyperkalaemia. He was sent to Nephrology Unit for dialysis, but the poor victim expired there about 48 hours after ingestion.DOI: http://dx.doi.org/10.3329/jom.v14i2.19687 J Medicine 2013, 14(2): 195-197

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