Relapse and Reinfection in Chronic Bacteriuria

Turck, Marvin; Anderson, Kenneth N.; Petersdorf, Robert G.

doi:10.1056/nejm196607142750203

Cited by 91 publications

(15 citation statements)

References 8 publications

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“…Recurrent UTI in women is a common problem [1][2][3][4]7,8], frequently leading to the use of long-term antimicrob ial therapy [9] with the attendant risks associated with such therapy [10] and expense involved in diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women

Privette

Cade

Peterson

et al. 1988

Nephron

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Twelve postmenopausal women who experienced frequent urinary tract infections were found to have atrophic vaginitis. Four of them who were taking sulfonamide preparations chronically also had an interstitial nephritis manifest by decreasing glomerular filtration rate and eosinophiluria. Treatment consisted of a Betadine douche daily for 1 week, administration of an appropriate nonsulfonamide antibiotic, and institution of estrogen therapy to restore glycogen deposition in the vaginal epithelium and promote return of a normal vaginal pH and bacterial flora. Prior to estrogen therapy, the frequency of infection was four per patient per year. During a follow-up observation period ranging from 2 to 8 years, there have been only four infections in the entire group. When sulfonamides were discontinued in the 4 patients with manifestations of interstitial nephritis, the eosinophiluria cleared, and the glomerular filtration rate increased significantly.

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Section: Discussionmentioning

confidence: 99%

Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women

Privette

Cade

Peterson

et al. 1988

Nephron

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“…Although lower UTIs respond well to antibiotics [11,25], the failure rate of pyelonephritis treatment is extremely high [6,8,26]. Several years ago, Bergeron [6] reviewed 31 studies published between 1957 and 1984; the failure rate was impressive in the 2305 patients followed for up to 4 months after antibiotic therapy.…”

Section: Failure Of Therapy For Pyelonephritismentioning

confidence: 99%

“…Although a high percentage of infections caused by E. coli and other nosocomial pathogens are reportedly resistant to antibiotics [22,26], given the availability of a wide selection of antimicrobials, bacterial resistance is rarely the cause treatment failure in pyelonephritis. Aminoglycosides and newer drugs, however, including third-generation cephalosporins, carbapenems (imipenem), monobactam (aztreonam), and quinolones, invariably eradicate these microbes [22].…”

Section: Failure Of Therapy For Pyelonephritismentioning

confidence: 99%

Pharmacologic basis for the treatment of pyelonephritis

Beauchamp

Bergeron²

1999

Curr Infect Dis Rep

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Urinary tract infections (UTIs) are among the most common bacterial infections in humans. Even though physicians have been treating UTIs for 60 years, there has been no standardized approach regarding the rational choice of antimicrobial agents and optimal treatment duration for these infections. This review discusses the pharmacologic basis for the treatment of UTIs. Although most antibiotics concentrate well in the urine and can eradicate most of the sensitive uropathogens that cause lower UTI, antibiotics given for the treatment of pyelonephritis must concentrate and kill bacteria embedded within the renal parenchyma. Investigators once believed that antibiotics must concentrate in sufficient amounts in the urine of infected patients to be effective in treating pyelonephritis. In fact, the efficacy of an antibiotic in the treatment of pyelonephritis is proportional to its capacity to converge in high concentration not only in urine but also in the renal parenchyma because serum and urine levels of antibiotics are poor predictors of the intrarenal levels. Other factors should also be taken into consideration in the management of UTIs, such as the time of day antibiotics are given because significant time-dependent differences have been observed in the pharmacokinetics and rate of excretion in urine of several antibiotics. Finally, the authors review the recent development in the inflammatory response in the urinary tract that may explain the clinical features of UTI and may be useful in the diagnosis as well as better management of UTI.

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“…The renal infection begins in the medulla which is particularly susceptible to infection because of the reduced blood flow, ammonia production and the direct effect of its hypertonicity resulting in decreased effectiveness of the polymorphonuclear phagocytes, and the possible inactivation of the fourth component of the complement system. 3 ' 35 Infection then spreads directly to the renal cortex. The infected portion of the kidney may heal by fibrosis leaving a scar on the surface of the kidney.…”

Section: Pathogenesismentioning

confidence: 99%

Urinary Tract Infection.

Qunibi

1982

Ann Saudi Med

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Relapse and Reinfection in Chronic Bacteriuria

Cited by 91 publications

References 8 publications

Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women

Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women

Pharmacologic basis for the treatment of pyelonephritis

Urinary Tract Infection.

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