Uncomplicated lower urinary tract infections are extremely common in women. Antibiotic treatment for acute episodes and for recurrence prophylaxis has its drawbacks and alternative therapies are sought in order to reduce the antimicrobial resistance phenomenon and the intestinal dismicrobism expansion. There are few studies on the effect of combination of cranberry extract with D-mannose in acute urinary tract infection management. In a pilot, randomized study 93 non-pregnant, otherwise healthy women, were enrolled with mean age of 39.77±10.36, diagnosed with uncomplicated lower urinary tract infection. Medical history, clinical examination, urine culture and a list of complaints were noted at the baseline visit. In a first phase of the study, treatment with either guideline recommended antibiotic alone or in association with the investigated product (cranberry extract plus D-mannose) was prescribed and all patients were clinically examined at day 7. All ameliorated and cured patients received in a second phase of the study, in a double-blind manner, prophylaxis with the investigated product or placebo for another 21 days, then a second clinical examination and a check of the list of complaints were performed. The cure rates were higher at day 7 when investigated product was added to antibiotic (91.6 vs. 84.4%). In resistant strains, a significantly higher cure rate was shown when the investigated product was added to antibiotic prescribed (88.8 vs. 37.5%, P<0.0001). The effect of cranberry extract plus D-mannose combination in acute urinary tract infection episodes seems to be promising. The significant cure rate registered in the patients with antibiotic-resistant urine cultures may be explained by a beneficial influence of the product on the antimicrobial sensitivity. Further studies are needed on this subject.
The term “rhabdomyolysis” defines a clinical and biological syndrome, potentially life-threatening, that occurs after the lysis of skeletal striated muscle fibers whose contents are released into the general circulation. The development of rhabdomyolysis can be associated with a wide variety of diseases, injuries, drugs, toxins and various viral infections. Recently, SARS-coV-2 has been reported as the cause of rhabdomyolysis, especially in those with severe forms of COVID-19. Very few cases describe the occurrence of this syndrome in patients with moderate forms of the disease. We will present the case of a patient with a mild to moderate form of the SARS-CoV-2 infection in contrast to the rhabdomyolysis syndrome, and also the lack of kidney damage.
With their high prevalence and predisposition to recurrence, urinary tract infections are important contributors to antibiotic prescription worldwide. Studies involving alternative urinary tract infections treatments emerged as a priority in the last years, developing as a response to rapid global dissemination of multi-drug resistant uropathogens. One of these non-antibiotic strategies is based on the hypothesis that recurrent and severe forms of urinary tract infections have a genetic susceptibility pattern, involving the variability of the innate immune response to germs aggression. Yet insufficient studied, the immunology of urinary tract infections is still a subject for new bold researches. By focusing the precise defect that leads to predisposition towards severe or recurrent evolution of the disease and by targeting to correct them, these new therapies examples outlined in our review can bring a ray of hope in the treatment of UTI and the burden they represent.
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