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)

Ceftriaxone has a very long serum half-life and enhanced in vitro activity against common pediatric pathogens. Therefore we evaluated the efficacy and safety of once daily ceftriaxone therapy in 57 children with serious infections including: meningitis (26 patients); ventriculitis (3); pyelonephritis (7); osteomyelitis (6); abscess (4); septic arthritis (3); sepsis (2); and miscellaneous infections (6). The most common isolates were Haemophilus influenzae (23), Escherichia coli (9) and Staphylococcus aureus (8). Ceftriaxone was given intravenously or intramuscularly in a dose of 50 mg/kg for non-central nervous system (CNS) infections. Patients with CNS infections received an initial dose of 100 mg/kg followed by 80 mg/kg 12 hours later and once daily thereafter. In a limited number of patients no major differences in serum ceftriaxone concentrations were found after intravenous or intramuscular injection. Of 57 patients with pathogens isolated 55 were completely cured; in one patient with Klebsiella pneumoniae ventriculitis, intraventricular gentamicin was briefly added to the regimen. Another patient with an anaerobic liver abscess recovered after metronidazole was administered. In three patients a delayed response to ceftriaxone was noted. One patient with previous recurrent infections had a second episode of H. influenzae meningitis 22 days after cessation of therapy. Clinical side effects were noted in 10 of 71 patients (including 14 treated patients who had negative cultures). Seven patients had diarrhea, one each had fever or rash and one had fever, rash and arthralgia. Laboratory side effects in 16 of 71 patients included eosinophilia (7), thrombocytosis (7), elevated liver enzymes (4) and leukopenia and neutropenia (2).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Once daily ceftriaxone for central nervous system infections and other serious pediatric infections. 372 39

Acute pyelonephritis is one of the most common serious medical complications of pregnancy and may result in significant maternal morbidity. E. coli and Klebsiella are the two most common causative organisms. Pregnant women with acute pyelonephritis should be hospitalized and treated with parenteral antibiotics. Clinical response is usually dramatic, with the majority of patients being asymptomatic within 48 to 72 hours of therapy. Recurrent infection is common, and these women must be followed closely with frequent surveillance cultures. Detection and eradication of bacteriuria at the initial prenatal visit is important in preventing this complication.
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PMID:Acute pyelonephritis in pregnancy. 379 31

A group of 27 female and 2 male urological patients, aged 19 to 80 years (mean 44 years), were treated with intravenous temocillin 500 mg twice daily for 5 to 7 days. The diagnoses were acute pyelonephritis (n = 20), acute cystitis (n = 6), and acute cystitis and pyelonephritis combined (3). The causative organisms were Escherichia coli (n = 20). Proteus species (n = 9). Klebsiella species (n = 4). Streptococcus faecalis (n = 2). Staphylococcus epidermidis (n = 1), and Providencia stuartii (n = 1). 27 of the 29 patients (93%) were clinically and bacteriologically cured; bacteriuria persisted in 2 patients with prolonged obstructive uropathy. In acute non-obstructive pyelonephritis, the urinary excretion of beta-2-microglobulin rapidly decreased, documenting a prompt renal tubular restitution during therapy. The drug was well tolerated and proved very safe with regard to haematological, hepatic and renal parameters. Also, Candida haemagglutination titres did not increase significantly during therapy. Temocillin therapy should preferably be commenced after the results of the urine culture are available.
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PMID:Clinical evaluation of temocillin in urinary tract infections. 389 36

Cefmenoxime, a new cephalosporin, was given to fifty patients (28 male and 22 female) aged 15 to 86 years with infection of the urinary tract or prostate. Urinary tract infections, i.e. cystitis in 20 cases and pyelonephritis in 21, were usually chronic and associated with urologic anomalies. Nine patients had infection of the prostate. Pathogens recovered from the urine were 26 E. coli, 8 Klebsiella, 16 Serratia, 5 Proteus mirabilis or indole-positive Proteus, 1 Providencia, and 4 Pseudomonas. Minimal inhibitory concentrations of cefmenoxime ranged from 0.015 to 64 micrograms/ml (mean MIC: 0.12 micrograms/ml). Cefmenoxime was given as single drug therapy in all patients but one, in a daily dosage of 2 g divided into two intramuscular injections, for 3 to 28 days (average 22 days). Follow-up after discontinuation of treatment was four weeks. Therapeutic results were as follows: 13 successes and 7 failures by relapse for the 20 cystitis patients, 13 successes and 7 failures by relapse for the 20 interpretable cases of pyelonephritis, and 4 successes and 5 failures by relapse for the 9 patients with prostate infection. Local tolerance was excellent. Skin rash in 2 patients and diarrhea in 1 required withdrawal of the drug. Three other patients with diarrhea were able to continue treatment. Intolerance to ingestion of alcoholic beverages was reported by 10 patients. Hypereosinophilia was recorded in 2 cases and a transient mononucleosic reaction in one. No renal of hepatic side effects were documented.
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PMID:[Clinical evaluation of cefmenoxime in urinary tract and prostatic infections]. 389 62

A two-stage protocol designed to evaluate putative immunomodulators for use in infectious disease has been proposed. In this report the effect of bestatin on a series of clinically relevant, and sub-lethal infections is described. Pyelonephritis, peritonitis and bacteremia were induced with Escherichia coli, while Klebsiella pneumoniae was used to produce a lung infection. Bestatin had no effect on the course of these infections. In a further experiment we assessed the effect of combined bestatin/antibiotic therapy on the course of renal infection. Again no effect was observed. These findings are consistent with the known immunomodulatory properties of bestatin. This methodology will be used to evaluate selected agents for their potential in infectious disease and should lead to useful clinical protocols.
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PMID:Immunopotentiation in infectious disease, II. Effect of bestatin on experimental infection. 390 58

Aztreonam was administered to a total of 681 patients with urinary tract infections due to susceptible gram-negative bacteria; 56 patients received a single 1-g intramuscular dose for acute uncomplicated cystitis, and 625 patients received multiple parenteral doses (usually a five-day course of 1 g two or three times daily) for a variety of urinary tract infections, including pyelonephritis, cystitis, prostatitis, and epididymitis. Microbiologic cure was achieved in 84% of patients in the single-dose study and in 85% of patients in the multiple-dose studies. In the latter studies the microbiologic cure rates for infections with Escherichia coli, the Klebsiella-Enterobacter-Serratia group, and Pseudomonas aeruginosa were 87%, 90%, and 76%, respectively. In a comparative study of aztreonam and cefamandole, the overall microbiologic cure rates were 89% and 80%, respectively. Of the 625 patients receiving multiple-dose therapy, 149 had urinary tract infections due to multiply drug-resistant bacteria; among these patients the microbiologic cure rate was 93%. Aztreonam constitutes effective therapy for urinary tract infections due to susceptible gram-negative bacilli.
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PMID:Summary of worldwide clinical trials of aztreonam in patients with urinary tract infections. 390 36

Timentin (ticarcillin (TCR) + clavulanic acid (AC)) was given for severe bacterial infections to sixteen hospitalized patients (10 male and 6 female; 16 to 75 years of age; normal renal function in 12). Infections included 8 septicemias (of which 4 were secondary to pyelonephritis), 6 pyelonephritis (in addition to the four above-mentioned cases), and 3 suppurated cellulitis of the lower limbs (with septicemia in one case). The following bacteria were recovered: 10 Escherichia coli, 1 Pseudomonas aeruginosa, 1 Enterobacter cloacae, 1 Providencia stuartii, 1 Salmonella typhi, 1 Klebsiella pneumoniae, and 1 Staphylococcus aureus. The sixteen strains were all susceptible to timentin (MICs determined by agar dilution: TCR + AC 4 mg/l: 0.5-16 mg/l; TCR + AC 8 mg/l: 0.2-16 mg/l). Thirteen strains were susceptible to TCR (MIC less than or equal to 16 mg/l), and three (1 E. coli, 1 K. pneumoniae, and 1 S. aureus) were resistant to TCR (MIC greater than or equal to 256 mg/l). 14 patients received timentin alone, while two were also given dibekacin. Timentin was given in one-hour IV infusions in a dosage of 9.6 g/24 h (3.2 g X 3) in 10 patients and 6.4 g/24 h (3.2 g X 2) in 6. Duration of therapy was 14 to 16 days in half of cases (range 5 to 21 days). At termination of the infusion, serum concentrations of ticarcillin and clavulanic acid (determined in ten patients) were greater than 50 mg/l and 3-7.4 mg/l respectively, and serum bactericidal activity (evaluated in ten cases) was consistently less than 1/2.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical evaluation of a ticarcillin-clavulanic acid combination in severe infections in adults]. 393 32

The authors studied the etiological spectrum of 226 patients with chronic pyelonephritis, with 926 microbic strains isolated from the urocultures. The most frequent microbic causative agents were E. coli (40,82%), Proteus (a total of 17,82%), Enterobacter (8,86%), Klebsiella (8,64%), Pseudomonas (6,16%), Enterococcus (5,94%). The drug susceptibility of the majority of the isolated gram-negative microorganisms versus ampicillin and chloramphenicol, widely used in out-patient department practice, is relatively low. An important condition for the effectiveness of the treatment is the consideration given to the susceptibility of the microbic strains, isolated from the uroculture.
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PMID:[Microbial spectrum in chronic pyelonephritis and the drug sensitivity of the microorganisms]. 402 20

The efficacy and safety of ticarcillin plus clavulanate potassium and piperacillin were compared in a clinical trial of 78 hospitalized patients with urinary tract infections. There were 37 evaluable patients in the ticarcillin plus clavulanate potassium-treated group and 39 in the piperacillin-treated group. The 43 infection sites in each group were primarily complicated pyelonephritis or complicated cystitis; six patients in the ticarcillin plus clavulanate potassium-treated group and four in the piperacillin-treated group also had septicemia. Both ticarcillin (3 g) plus clavulanate potassium (200 mg) and piperacillin (125 to 200 mg/kg per day) were administered intravenously. The 43 most common pathogens in each treatment group were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa from the urinary tract and E. coli from the blood. Eight pathogens in the ticarcillin plus clavulanate potassium-treated group and 11 in the piperacillin-treated group were resistant to ticarcillin in vitro. Eradication was achieved for 39 of the 43 (91 percent) pathogens in the ticarcillin plus clavulanate potassium group, including all six organisms isolated from the blood and eight (89 percent) of the ticarcillin-resistant pathogens. In the piperacillin-treated group, 33 of the 43 (77 percent) pathogens were eradicated, including three of the four blood isolates but only eight (73 percent) of the ticarcillin-resistant pathogens. The rate of reinfection or relapse was similar in both groups. Clinical cure or improvement occurred in 97 percent of the patients in each group. Mild and transient increases in levels of liver enzymes or eosinophilia was reported for 11 patients in the ticarcillin plus clavulanate potassium-treated group and for seven in the piperacillin-treated group. In one patient in the ticarcillin plus clavulanate potassium-treated group, a drug-related rash and nausea developed, and treatment was discontinued.
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PMID:Comparative study of ticarcillin plus clavulanate potassium versus piperacillin in the treatment of hospitalized patients with urinary tract infections. 407 1

In a comparative study, 47 patients received Timentin, a combination of ticarcillin plus clavulanic acid, or piperacillin to treat serious urinary tract infections. Thirty-nine infections in 38 patients were clinically evaluable (21 in the Timentin-treated group and 18 in the piperacillin-treated group). These included pyelonephritis (10 in the Timentin-treated group and five in the piperacillin-treated group), bladder infections with sepsis (11 in the Timentin-treated group and 11 in the piperacillin-treated group) and bladder infections without fever (two in the piperacillin-treated group). The addition of clavulanic acid to ticarcillin greatly enhanced the susceptibility of five of the 28 evaluable pathogens in the Timentin-treated group (two Escherichia coli isolates, two Staphylococcus aureus isolates, and one Klebsiella pneumoniae isolate). The minimal inhibitory concentrations at which 50 and 90 percent of the bacterial growth was inhibited were 4 and 64 micrograms/ml, respectively, for Timentin, and 4 and 32 micrograms/ml, respectively, for piperacillin. All evaluable patients had a satisfactory symptomatic response at the end of the trial. Of 28 evaluable pathogens treated with Timentin, 18 were eradicated up through the one-week post-therapy evaluation period; of 27 evaluable pathogens treated with piperacillin, 18 were eradicated up through the same time period. Eradicated pathogens included E. coli (six of 13 in the Timentin-treated group and six of 11 in the piperacillin-treated group), other Enterobacteriaceae (three of three in the Timentin-treated group and eight of 10 in the piperacillin-treated group), Pseudomonas aeruginosa (two of four in the piperacillin-treated group), enterococcus (two of three in the Timentin-treated group and two of two in the piperacillin-treated group), staphylococcal species (four of five in the Timentin-treated group), and other organisms (three of four in the Timentin-treated group). Resistance did not develop in any of the persisting pathogens. Adverse effects thought possibly to be related to the study drugs were minimal and included rash in one Timentin-treated patient and diarrhea in another.
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PMID:Timentin versus piperacillin in the therapy of serious urinary tract infections. 407 2


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