Extended Therapy in Patients with Established Urinary Tract Infection

1971 ◽  
Vol 16 (3) ◽  
pp. 169-172
Author(s):  
D. H. Lawson ◽  
R. I. Gleadle ◽  
A. L. Linton
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Recurrence Rate ◽  
Impaired Renal Function ◽  
Renal Damage ◽  
Initial Therapy ◽  
Intravenous Pyelography ◽  
Acute Urinary Tract Infection

Sixty-six patients with established urinary tract infection were given a 3-month course of antibacterial therapy and the effect of this upon the recurrence rate of urine infections investigated. Even in patients with no radiological evidence of renal damage the recurrence rate was 40 per cent at 2 years and this rose to 75 per cent in the group with impaired renal function and abnormalities present on intravenous pyelography. It is concluded that an initial 10 day course of therapy is indicated in females suffering from their first or second attack of acute urinary tract infection. If this becomes established, a 3-month course of therapy is suggested and following this, further recurrences demand careful renal investigation. In the male, all cases of urinary tract infection should be investigated after the initial therapy. Finally, the management of those patients with no anatomical lesion who suffer from recurrent attacks of infection after a 3-month course of therapy has not yet been clearly defined. There is no evidence that either ampicillin, nitrofurantoin or nalidixic acid is superior to sulphadimidine in the treatment of patients with established urinary tract infection.

scholarly journals Urinary tract infection in small children: the evolution of renal damage over time

2017 ◽  
Vol 32 (10) ◽  
pp. 1907-1913 ◽  
Author(s):  
Svante Swerkersson ◽  
Ulf Jodal ◽  
Rune Sixt ◽  
Eira Stokland ◽  
Sverker Hansson
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Renal Damage ◽  
Small Children ◽  
Over Time

Trimethoprim in acute urinary tract infection

1980 ◽  
Vol 18 (13) ◽  
pp. 51-52
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Urinary Tract Infection

Trimethoprim (Trimopan - Berk; Ipral - Squibb; Syraprim - Wellcome) is now marketed here for the prophylaxis and treatment of urinary tract infection. Hitherto it has only been available either combined with sulphamethoxazole as co-trimoxazole (Septrin; Bactrim), which is particularly well established in the treatment of urinary tract infection, or with sulphadiazine as co-trimazine (Coptin), a combination we reviewed recently.1 Trimethoprim has been available alone in Finland since 1973.

Ultrasonography in the Radiologic Evaluation of Children With Urinary Tract Infection

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Uri Alon ◽  
Menucha Pery ◽  
Giora Davidai ◽  
Moshe Berant
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Hospitalized Patients ◽  
Voiding Cystourethrography ◽  
Urinary System ◽  
Intravenous Pyelography ◽  
Early Screening ◽  
Radiologic Evaluation ◽  
Radiologic Workup

A prospective blind study comparing the findings of ultrasonography, intravenous pyelography, and voiding cystourethrography was conducted on 81 patients to examine the place of ultrasonography in the initial radiologic evaluation of children with urinary tract infection. The patients' mean age was 4.8 years; 15 were male. Forty-eight were inpatients (mean age, 3.2 years) and 33 were outpatients (mean age, 7.2 years). In 29 patients (35.8%) abnormality of the urinary system was detected by one or more of the three imaging procedures; 21 were inpatients and eight were outpatients. The most frequent finding was vesicoureteral reflux, occurring in 62.1% of the pathologic cases. The findings at ultrasonography correlated well with those of intravenous pyelography in 73 of the 81 studies (90.1%), but they failed to demonstrate double collecting systems and several of the minor changes. However, ultrasonography in combination with cystourethrography identified all patients who had abnormal urinary systems, except for two children with negligible findings. Moreover, ultrasonography and cystourethrography together identified all 11 patients, nine of them inpatients, in whom surgical treatment was indicated. It is concluded that ultrasonography can successfully replace intravenous pyelography as a screening imaging procedure for the urinary system, but because of the superiority of intravenous pyelography in the detection of some types of lesions, intravenous pyelography will be required whenever ultrasonography or cystourethrography results are abnormal. Accordingly, and in view of the differences in the frequency and severity of pathologic findings between outpatients and hospitalized patients, the following protocol is suggested for the radiologic evaluation of children with urinary tract infection: For outpatients, cystourethrography can be performed 4 to 6 weeks after cessation of antibiotic therapy. If the study is normal, ultrasonography can be done; if this is also normal, no further radiologic workup is needed. Only when cystourethrography or ultrasonography findings are abnormal is intravenous pyelography also indicated. For hospitalized patients, especially young children, ultrasonography can be used as the early screening procedure, within two to four days after the diagnosis of urinary tract infection. If the results are normal, cystourethrography can follow after 4 to 6 weeks; if abnormal, cystourethrography can be performed after ten to 14 days. Here, too, intravenous pyelography is needed only when ultrasonography and/or cystourethrography results are abnormal.

scholarly journals Population Pharmacokinetic and Pharmacokinetic/Pharmacodynamic Analyses of Cefiderocol, a Parenteral Siderophore Cephalosporin, in Patients with Pneumonia, Bloodstream Infection/Sepsis, or Complicated Urinary Tract Infection

2020 ◽  
Author(s):  
Nao Kawaguchi ◽  
Takayuki Katsube ◽  
Roger Echols ◽  
Toshihiro Wajima
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bloodstream Infection ◽  
Plasma Concentrations ◽  
Complicated Urinary Tract Infection ◽  
Population Pharmacokinetic ◽  
Dosing Regimen ◽  
Population Pk

Cefiderocol is a novel siderophore cephalosporin with antibacterial activity against Gramnegative bacteria including carbapenemresistant strains. The standard dosing regimen of cefiderocol is 2 g administered every 8 hours over 3 hours infusion in patients with creatinine clearance (CrCL) of 60 to 119 mL/min, and it is adjusted for patients with < 60 mL/min or ≥ 120 mL/min CrCL. A population pharmacokinetic (PK) model was constructed using 3427 plasma concentrations from 91 uninfected subjects and 425 infected patients with pneumonia, bloodstream infection/sepsis (BSI/sepsis), and complicated urinary tract infection (cUTI). Plasma cefiderocol concentrations were adequately described by the population PK model, and CrCL was the most significant covariate. No other factors including infection sites and mechanical ventilation were clinically relevant, although the effect of infection sites was identified as a statistically significant covariate in the population PK analysis. No clear pharmacokinetic/pharmacodynamic relationship was found for any of the microbiological outcome, clinical outcome, or vital status. This is because the estimated percentage of time for which free plasma concentrations exceed the minimum inhibitory concentration (MIC) over dosing interval (%fT>MIC) was 100% in most of the enrolled patients. The probability of target attainment (PTA) for 100% fT>MIC was > 90% against MICs ≤ 4 μg/mL for all infection sites and renal function groups except for BSI/sepsis patients with normal renal function (85%). These study results support adequate plasma exposure can be achieved at the cefiderocol recommended dosing regimen for the infected patients including the patients with augmented renal function, ventilation, and/or severe illness.

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