Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amoxicillin (alpha-amino-p-hydroxybenzyl penicillin) is a new oral semisynthetic penicillin with antibacterial activity similar to that of ampicillin; however, it is more completely absorbed and urinary concentrations are higher. Twenty-seven patients during 28 episodes of urinary tract infection were treated with oral amoxicillin given either as 250- or 500-mg doses. Clinical cure or improvement occurred in 23 of 27 infections (85%); eradication of the responsible organisms occurred in 23 of 26 infections (88%); and both clinical cure or improvement and eradication occurred in 20 of 25 infections (80%). Three infections relapsed. Failure to respond bacteriologically was associated with resistant organisms in two patients and with chronic pyelonephritis (Proteus mirabilis) is one. Concentrations of amoxicillin in serum obtained 2 h after administration were more variable than those previously reported for reasons which were obscure. In vitro studies revealed amoxicillin to be comparable to ampicillin when tested against most gram-negative bacilli; however, in this situation amoxicillin may be more effective than ampicillin against enterococci.
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PMID:Clinical and laboratory evaluation of amoxicillin (BRL 2333) in the treatment of urinary tract infections. 459 43

The initial interaction between bacteria and the renal pelvic epithelium may determine whether intrarenal infection occurs. A model of retrograde pyelonephritis was employed to study these events by electron microscopy. Female rats received an intravesicular inoculation of a 0.5-ml suspension of Proteus mirabilis containing 10(8) organisms. At intervals after inoculation, the kidneys were fixed by intravascular perfusion and the tissues were prepared for electron microscopy. During the first 24 h, increasing numbers of bacteria were seen to be attached by pili to the renal pelvic epithelial cells. The organism appeared to cross the mucosal barrier by several mechanisms: (a) penetration into the cytoplasm of intact epithelial cells, (b) passage between epithelial cells that were separated by excessive hydrostatic pressure generated during bladder inoculation, (c) passage across necrotic regions of the pelvis, and (d) translocation to the cortex by calicotubular backflow. Whereas at inoculation bacteria possessed pili 40 A in diameter (type III pili) 24 h after reflux, the predominant type of pili measured 70 A in thickness (type IV pili). Repetitive subculture induced a similar transition in vitro. To assess the influence of pili type on virulence in this model, 80 rats were challenged with either type III or type IV pilated organisms and the frequency of rats with cortical abscesses were compared at 1 wk. A significantly greater number of rats inoculated with type IV pilated Proteus manifested macroscopic evidence of infection. These results suggest that pili play a role in the pathogenesis of ascending pyelonephritis.
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PMID:Host-parasite interaction in the rat renal pelvis: a possible role for pili in the pathogenesis of pyelonephritis. 461 81

In animals developing unilateral Proteus mirabilis-induced pyelonephritis, the total soluble renal lysozyme (SRL) of both kidneys undergoes a biphasic elevation. The second phase of elevated SRL is associated with the onset of chronicity in the infected kidney. To discover whether effective antibacterial therapy altered the second elevation of SRL, levels of SRL were determined in rats developing unilateral chronic pyelonephritis with and without effective regimens of antibacterial agents. Therapeutic doses of ampicillin and nitrofurantoin caused elevations of SRL in both kidneys of infected animals, but these differences were not statistically significant (P > 0.05). Both agents produce elevations of SRL in uninfected animals which were significant (P < 0.05) when compared with normal animals. Kanamycin sulfate at a therapeutic dose induced great elevations of SRL in kidneys of both infected and uninfected animals. It is concluded that infection per se is not the cause of the elevated SRL.
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PMID:Effect of antibacterial therapy on renal lysozyme levels in rats developing bacterial pyelonephritis. 461 54

The effectiveness of nitrofurantoin in suppressing bacterial growth in the urinary tract was evaluated by using two different experimental models. Pyelonephritis was produced in rats by direct inoculation of 10(4)Escherichia coli in the medulla of left kidney. Ascending urinary tract infection was induced by inoculation into the urinary bladder of 10(7)Proteus mirabilis, after a partial cystectomy. Nitrofurantoin was shown to be effective in suppressing bladder bacteriuria, in preventing ascending pyelonephritis, and also in preventing bacterial multiplication in kidney tissue following direct inoculation.
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PMID:Site of action of nitrofurantoin in experimental urinary tract infection. 490 33

A rat Proteus and Escherichia pyelonephritis model is described in which (i) reproducible chronic infections are achieved and (ii) the efficacy of clinically effective agents is reliably demonstrable with five rats in 17 days. It can serve as a primary screen in which one technician can evaluate 180 compounds per month with 900 rats. The manner of inoculation will inherently allow the study of and distinction between metabolism which is peculiar to infection and that which is characteristic of trauma and healing in general for the elucidation of chemical correlations with effective therapy.
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PMID:Rat pyelonephritis model suitable for primary or secondary screening. 490 6

The induction of sterile unilateral pyelonephritis in rats with heat-killed Proteus mirabilis cells is described. The lesions were identical to those produced with viable bacteria. Lysozyme levels in both kidneys of rats developing unilateral sterile pyelonephritis underwent biphasic elevations similar to those produced with viable bacteria. In the injected kidney, the first elevation, associated with the trauma of injection, could be produced by injecting sterile saline. The second elevation was associated with the onset of chronicity in the injected kidney. The nonmanipulated, contralateral kidney showed a similar biphasic elevation, of equal duration but of greater magnitude.
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PMID:Renal lysozyme levels in animals developing "sterile pyelonephritis". 494 91

In vitro activities or excreted urinary activities of 56 generic and experimental drugs against two organisms commonly associated with human pyelonephritis, Escherichia coli and Proteus mirabilis, are not correlated with the in vivo activities of these compounds as measured by reduction of viable organisms in kidneys in experimental pyelonephritis.
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PMID:Pyelonephritis therapy in rats: random association with excreted urinary antibacterial activity. 549 10

In animals developing experimentally induced unilateral pyelonephritis, both the infected kidney (IK) and the contralateral noninfected kidney (NIK) showed an immediate increase in renal lysozyme activity of about 5 days' duration after the unilateral injection of viable Proteus mirabilis into the renal cortex. Lysozyme activities of the NIK were consistently higher than those of the IK. This initial increase was followed by a second increase which lasted throughout the period of observation (17 days), and enzyme activities of the NIK were consistently higher than those of the IK. In saline punctured kidneys of control animals, both the saline punctured kidney (SP) and the non-saline punctured kidney (NSP) showed only the immediate increase in renal lysozyme activity, which persisted until the SP was completely healed. These enzyme activities were less than those observed in the infected animals, but the response of the NSP was greater than that of the SP. Trauma not directed to the kidney does not produce a similar response of renal lysozyme. The elevated renal lysozyme of the NIK could not be shown to protect it from bacterial infection.
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PMID:Renal lysozyme levels in animals developing Proteus mirabilis-induced pyelonephritis. 554 3

In this study, 63 patients with various urinary tract infections were treated with cefotaxime in different dosages. They were aged from 10 to 82 years (mean: 59). The cases included 33 cystitis, 25 pyelonephritis, 4 chronic prostatitis and 1 orchiepididymitis. 85 strains of enterobacteria were identified: 20 E. coli, 2 Citrobacter freundi, 5 Proteus mirabilis, 12 indole positive Proteus, 1 Providentia, 11 Klebsiella, 3 Enterobacter cloacae and 31 Serratia marescens and liquefaciens. 80 of these strains had MIC less than or equal to 1 mcg/ml (median: 0,12 mcg/ml). More than 2/3 of the patients were treated with a daily dose of 1.50 to 2 g, and 52 (median: 0.12 mcg/ml). More than 2/3 of the patients results showed 43 cures (9 of these with reinfection) and 20 relapses. Isolated enterobacteria strains were sensitive to cefotaxime in patients with recurrence. Relapses were due to underlying urological pathology. Among reinfection organisms, only one, an Enterobacter cloacae, was resistant to cefotaxime. The clinical, local, systemic and biological tolerance was good. Cefotaxime has been very effective in the treatment of severe urinary tract infections, especially in chronic pyelonephritis and cystitis, at an average daily dose of 2 g.
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PMID:[Clinical evaluation of cefotaxime at various dosage levels in urinary tract infections (author's transl)]. 625 7

Ceftizoxime, a new cephalosporin preparation, was evaluated for its antibacterial activity, absorption, excretion and clinical effectiveness, and the following results were obtained. The minimum inhibitory concentrations (MICs) of ceftizoxime against 211 clinical isolates were determined in comparison with those of cefazolin, cefmetazole, cefotiam and 6059 S. Against S. pyogenes (50 strains), ceftizoxime was 1 tube inferior to cefazolin inoculum size of 10(8) cells/ml, but was 2--3 tubes superior to cefmetazole and 6059-S. Against E. coli (50 strains), ceftizoxime and 6059-S were significantly more active than the other drugs. The susceptibility pattern of Klebsiella sp. (50 strains) to ceftizoxime was similar to that to cefotiam and 6059-S. Against Proteus sp. (50 strains), cefotiam and 6059-S were more active than the other drugs. Ceftizoxime was intermediate in activity, and cefazolin was the least active. Against H. influenzae (11 strains), ceftizoxime was the most active, with concentrations of 0.1 mcg/ml required to inhibit 100% of strains with an inoculum size of 10(8) cells/ml and 10(6) cells/ml. A dose of ceftizoxime 10 mg/kg or 20 mg/kg was administered to 15 patients aged from 5 years to 12 years, and serum levels and urinary excretion of the drug were measured. Intravenous bolus injection of the drug in dose of 10 mg/kg and 20 mg/kg yielded mean serum levels of 26.6 mcg/ml and 55.7 mcg/ml at 30 minutes, respectively. The serum levels of the drug, thereafter, declined gradually but still remained 1.3 mcg/ml and 2.7 mcg/ml at 6 hours. The serum half-lives (T 1/2) were estimated to be 1.17 hours in dose of 10 mg/kg and 1.31 hours in dose of 20 mg/kg. When a dose of 20 mg/kg was infused over a period of 30 minutes, the serum levels attained the peak of 72.4 mcg/ml to 82.4 mcg/ml (mean 79.4 mcg/ml) at the end of infusion. The levels, thereafter, tapered to mean levels of 45.3 mcg/ml at 30 minutes, 24.7 mcg/ml at 1 1/2 hours, and 3.6 mcg/ml at 5 1/2 hours, with a T 1/2 of 1.22 hours. Meanwhile, when the same dose was infused over 1 hour, the serum levels attained the peak of 59.4 mcg/ml to 68.5 mcg/ml (mean 64.2 mcg/ml). The mean serum levels after the end of infusion were 41.3 mcg/ml at 30 minutes, 21.6 mcg/ml at 1 hour and 1.9 mcg/ml at 5 hours, with a T 1/2 of 0.97 hours. Urinary recovery of the drug was 69.2% to 79.9% after intravenous injection and 62.3% to 79.9% after drip infusion, most of the given drug was excreted in the first 2 hours after administration. In our clinical study, 27 children with moderate or severe infections (12 cases of bronchopneumonia or bronchitis, 5 of pyelonephritis, 3 of purulent meningitis, etc.) were treated with ceftizoxime at the daily dose of 30--309 mg/kg for 3--23 days. Clinical response was excellent in 10, good in 9, fair in 5 and poor in 3. The drug was proved to be very effective against infections due to H. influenzae K. pneumoniae, E. coli and S. aureus. No serious side effects were observed in any case.
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PMID:[Laboratory and clinical studies on ceftizoxime in the field of pediatrics (author's transl)]. 627 16


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