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 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A new sulfonamide, sulfacytine, was compared in a double-blind study with sulfisoxazole for the treatment of acute uncomplicated urinary tract infection in 98 outpatients. Patients received either 4 gm. sulfisoxazole or 1 gm. sulfacytine daily for 10 days. Evaluation was made of the bacteriologic and clinical success within the period of treatment and at some point after treatment. Bacteriologic success, or reduction of urine bacterial count from 100,000 or more micro-organisms per ml. to 1,000 or less, was observed in 95 to 100 per cent of the patients in each group during treatment as well as at the post-treatment evaluation. Clinical success, or the abolition of dysuria and frequency of urination and the reduction of pyuria to less than 10 white blood cells per high power field, was observed in 75 to 85 per cent of the patients. Adverse reactions were rare, involving 1 instance each of headache, nausea and hematuria in the sulfisoxazole group, and drug attributability was only possibly established. Mild laboratory abnormalities occurred in each group, 2 cases each of decreased white blood count and 1 instance of a lowered hemoglobin in a patient in the sulfacytine group. The results of our study seem to indicate that sulfacytine is an effective drug for the treatment of acute uncomplicated urinary tract infections.
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PMID:Sulfacytine: a new sulfonamide. Double-blind comparison with sulfisoxazole in acute uncomplicated urinary tract infections. 119 74

The efficacy and safety of 7-10-day courses of lomefloxacin (single daily dose of 400 mg) or norfloxacin (twice-daily doses of 400 mg) for the treatment of uncomplicated urinary tract infections were compared in two large, multicenter, randomized trials. This article presents the combined results of these trials, which were conducted in a total of 27 centers throughout the United States. A total of 727 adults, mostly women, with symptoms of acute urinary tract infection were enrolled; 370 patients were randomized to lomefloxacin treatment, and 357 received norfloxacin. The bacteriologic cure rate at 5-9 days post-therapy was 98.2% in the lomefloxacin group and 96.3% in the norfloxacin group (p = nonsignificant). The clinical success rate of 99.1% in the lomefloxacin group was significantly higher than the success rate of 93.5% in the norfloxacin group (p = 0.002). Adverse events were reported by 157 lomefloxacin-treated patients and 129 patients receiving norfloxacin. Adverse events attributable to drug treatment occurred in 41 patients (11.1%) in the lomefloxacin group and 27 (7.6%) in the norfloxacin group. Eight lomefloxacin (2.2%) and three norfloxacin patients (0.8%) were withdrawn from treatment because of adverse events probably attributable to the drug. The incidence of dizziness, tremor, and photosensitivity rash was higher in the lomefloxacin group than in the norfloxacin group, while the incidence of nausea was higher in the norfloxacin group. The results of these trials demonstrate that once-daily administration of 400 mg lomefloxacin is as safe and effective clinically as, and superior bacteriologically to, twice-daily administration of 400 mg norfloxacin in the treatment of acute uncomplicated urinary tract infections in adult patients.
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PMID:Efficacy of lomefloxacin as compared to norfloxacin in the treatment of uncomplicated urinary tract infections in adults. 131 75

Temafloxacin is a new fluoroquinolone that achieves a high urine concentration and has potent, broad-spectrum antimicrobial activity against most pathogens associated with urinary tract infections. The clinical efficacy and safety of temafloxacin were assessed in adult females with acute, uncomplicated urinary tract infection in a series of three randomized, double-blind trials. A total of 555 clinically evaluable females of 919 enrolled from 75 centers received temafloxacin 200 or 400 mg once daily for 3 or 7 days, or a control regimen. The latter consisted of trimethoprim/sulfamethoxazole 160 mg/800 mg, ciprofloxacin 250 mg, or norfloxacin 400 mg, each given twice daily for 7-10 days. Clinical cure or improvement occurred in 305 of 308 temafloxacin patients (99%) and in 247 of 247 controls (100%). Corresponding bacterial eradication rates were 99% (289/292) and 96.7% (237/245), respectively. The most frequently observed adverse events were nausea (3.5% of the temafloxacin group, 6.5% of the reference quinolone group, and 6.6% of the trimethoprim/sulfamethoxazole group) and headache (5.4%, 3.7%, and 3.1% of the same respective groups). These results demonstrate the clinical efficacy and safety of temafloxacin, given once daily, in a large number of females with acute, uncomplicated urinary tract infection.
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PMID:Treatment of uncomplicated urinary tract infections with temafloxacin. 166 82

The role of operative intervention for hereditary pancreatitis, a rare form of chronic parenchymal destruction, is unclear. To determine whether surgical therapy is safe and provides prolonged symptomatic relief, the authors reviewed the management of 22 adults (11 men, 11 women) with hereditary pancreatitis treated surgically between 1950 and 1989. Hereditary pancreatitis was defined as a family history of two or more relatives with pancreatitis and clinical, biochemical, or radiologic evidence of pancreatitis. The mean ages at onset of symptoms and at operation were 15 years (range, 3 to 52 years) and 31 years (range, 18 to 54 years), respectively. Pain was the primary indication for operation in all patients. Additional symptoms included nausea, vomiting (73%), weight loss (55%), and diarrhea (41%). Ductal dilatation was present in 68%, pancreatic parenchymal calcifications in 73%, pseudocysts in 36%, and splenic vein thrombosis in 18%. Primary operations included ductal drainage in 10 patients, pancreatic resection alone in three, resection with drainage in three, cholecystectomy plus sphincteroplasty in two, cholecystectomy with or without common bile duct exploration in two, pancreatic abscess drainage in one, and pseudocyst drainage in one. There were no perioperative deaths, and the morbidity rate was 14% (intra-abdominal abscess, wound infection, and urinary tract infection). Symptoms recurred in nine patients. Severity prompted reoperation in five. Secondary operations included pancreatic resection in three, pseudocyst excision in one, and pancreaticolithotomy in one. Follow-up to date is complete and extends for a median of 85 months. Eighteen patients (82%) are clinically improved or asymptomatic. Symptoms have persisted in four patients, and two patients have died of pancreatic carcinoma. Two patients died of unrelated causes. Surgical therapy for patients with hereditary pancreatitis selected on the basis of the traditional indications for surgical treatment of chronic pancreatitis is safe and efficacious.
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PMID:The surgical spectrum of hereditary pancreatitis in adults. 173 48

In this series, nine pregnant patients had appendectomy. Seven patients had acute appendicitis; pyuria and symptoms suggesting urinary tract infection delayed diagnosis in one whose appendix perforated. Abdominal pain and nausea with or without vomiting were presenting symptoms in all of the patients. Tenderness in the right lower quadrant was present in six. Eight patients, including two with a normal appendix, had leukocytosis with a left shift. There was no fetal or maternal loss. In addition, I reviewed more than 900 other cases of appendectomy during pregnancy, as reported in the literature since 1960. Among 713 previously reported cases of confirmed appendicitis, rupture had occurred in 25%. There were five maternal deaths, all in the group of patients with perforation. Perinatal mortality was 4.8% among patients with acute inflammation only and 19.4% in those with perforative appendicitis. The diagnosis rests on clinical acumen, and prompt surgical intervention is the key to good outcome.
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PMID:Appendicitis complicating pregnancy. 173 28

Cefprozil is a new oral semi-synthetic cephalosporin with broad antibacterial spectrum and prolonged serum elimination half-life. In vitro, cefprozil demonstrates excellent activity against common urinary tract pathogens such as Escherichia coli and Klebsiella pneumoniae. Cefprozil, 500 mg once a day, was compared to cefaclor, 250 mg three times a day, in an open, randomized, comparative, clinical trial for the treatment of acute, uncomplicated, urinary tract infection. One hundred and two adult patients were eligible for safety evaluation; four patients were excluded due to side-effects (abdominal discomfort, nausea and vomiting). Ninety-eight patients were eligible for evaluation of efficacy. Clinical and bacteriological responses were comparable for both antibiotics. Leucopenia, nausea, and vaginal yeast infections were slightly more common in the cefprozil group. Cefprozil, 500 mg once daily, appears to be an appropriate alternative for the treatment of acute, uncomplicated urinary tract infections.
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PMID:Comparative efficacy and safety of cefprozil and cefaclor in the treatment of acute uncomplicated urinary tract infections. 176 53

The choice of therapy in urinary tract infections depends on the infection site, complications, previous history, and recrudescence. Acute uncomplicated urinary tract infections which do not respond to general measures as increased fluid intake will be cured with antibiotics for 3 days. If the compliance of the patient is sufficient a single shot therapy may be applied. Infections of the upper urinary tract with typical signs such as fever, nausea and increase of the so-called acute phase proteins have to be treated with antibiotics for 7 to 14 days. When treating the first episode of urinary tract infection the choice of antibiotics is unimportant. Trimethoprim and quinolones are standard. In recurrent infections urine cultures and susceptibility testing are mandatory. Patients with recurrent urinary tract infections should receive a long-term suppressive therapy with low-dose trimethoprim or a quinolone. Patients with urinary catheters must not receive any long-term therapy.
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PMID:[Therapy of urinary tract infection]. 181 94

In a double-blind, randomized, multicenter study, 400 women with symptoms of acute urinary tract infections were treated with either a 7-day course of temafloxacin hydrochloride (400 mg once a day; n = 204) or a 10-day course of trimethoprim (160 mg) and sulfamethoxazole (800 mg) (TMP-SMZ) twice daily (n = 196). The bacteriologic cure rates at 5 to 9 days posttherapy were 100% in the temafloxacin group and 97% in the TMP-SMZ group (P = 0.035). The clinical cure rates were 93% in the temafloxacin group and 95% in the TMP-SMZ group (P greater than 0.1). Adverse events, including nausea, vomiting, rash, headache, and dizziness, were experienced by 19.6% of the temafloxacin group and 23.5% of the TMP-SMZ group. Transient leukopenia occurred in 0.5 and 4.1% of the temafloxacin and TMP-SMZ groups, respectively. Temafloxacin, 400 mg once a day for 7 days, appears to be at least as safe and effective as a 10-day course of TMP-SMZ in the management of acute urinary tract infection in women.
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PMID:Comparative, double-blind, prospective, multicenter trial of temafloxacin versus trimethoprim-sulfamethoxazole in uncomplicated urinary tract infections in women. 195 47

Ofloxacin was administered orally at a daily dosage of 300 mg and 600 mg in three divided doses for 14 days to 24 and 60 patients with chronic complicated urinary infections, respectively, in order to evaluate the therapeutic efficacy. The clinical efficacy was evaluated according to the criterion proposed by the UTI Committee in Japan and its efficacy was evaluated in 84 cases. In the group of 24 patients receiving a daily dosage of 300 mg, the clinical effectiveness after a 5-day treatment was excellent in 13 cases and moderate in 7 cases. The overall clinical efficacy was 83.8%. In the group of 60 patients receiving a daily dosage of 600 mg, the rate of overall clinical efficacy after a 5-day treatment was 83.3%, being excellent in 23 cases and moderate in 27 cases. The eradication rate was 85.3% and 92.5% by 300 mg and 600 mg dosages of ofloxacin, respectively. As adverse reactions, anorexia and nausea occurred in 2 cases. Laboratory anomalies consisted of 1 case of slight and transient elevation of transaminase, and 1 case of elevated serum creatinine.
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PMID:[Clinical evaluation of ofloxacin in the treatment of chronic complicated urinary tract infection]. 223 69

Carumonam (CRMN), the first monobactam antibiotic in Japan, has excellent activity against gram-negative bacteria and is useful in the treatment of urinary tract infections. However, it may be insufficient in the treatment of complicated urinary tract infections because of the increase in isolation of gram-positive bacteria, and it may be necessary to co-administer antibiotics active against gram-positive organisms to achieve a broader spectrum of coverage in connection with severe infections. The combination of CRMN and fosfomycin (FOM) was evaluated for its effectiveness and safety at the Department of Urology, Yamagata University Hospital and 7 affiliated hospitals. Clinical efficacy was assessed on 64 patients with complicated urinary tract infection according to the Criteria for Clinical Evaluation of Antimicrobial Agents in UTI (3rd. ed.) recommended by the Japan UTI Committee. Clinical efficacy was evaluated as excellent in 16, moderate in 32, poor in 16, with an overall clinical effectiveness rate of 75.0%, which is superior compared with CRMN alone. Of the total of 92 bacterial strains isolated, 66 (71.7%) were eradicated. Subjective adverse reaction was seen in 1 patient (1.4%), as nausea and anorexia. Slight increases in serum GOT and GPT ware recorded in 5 patients (7.1%). These findings disappeared after the termination of administration without treatment. The combination of CRMN and FOM might therefore be useful in the treatment of complicated urinary tract infections.
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PMID:[Clinical evaluation of the combination of carumonam and fosfomycin in the treatment of complicated urinary tract infection]. 223 70


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