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

Bacteriuria in pregnancy occurs in about one in 20 pregnant women and is usually initially asymptomatic. It is an important marker for acute symptomatic infection (often pyelonephritis) later in pregnancy, which occurs in about one in four bacteriurics. Several considerations surround the antibiotic treatment of the asymptomatic infection; these include a low frequency of in vitro resistance to the agent used, lack of toxicity to the foetus, a low incidence of gastrointestinal side effects, good compliance and proven efficacy. Fosfomycin trometamol seems to fit these requirements. In three controlled studies (two multicentric) 250 patients were treated with fosfomycin trometamol in a 3 g (as fosfomycin) single dose; 197 patients were given one of three other agents. Cure rates for fosfomycin trometamol were 77-94% (68-94% for other agents), which was satisfactory in an infection which is sometimes difficult to eradicate. Further studies are needed in this important but accessible group of patients. Opportunities should be taken to study more foetal outcomes and provide more data on gastro-intestinal tolerability.
 ...
PMID:Treatment of bacteriuria in pregnancy with single dose fosfomycin trometamol: a review. 129 25

Bacteriuria in pregnancy, with or without clinical symptoms, is frequent. If left untreated, it can in 20-30% of cases lead to acute pyelonephritis, which is a serious threat to the mother and fetus, increasing the risk of preterm labour and low birthweight infants. This paper is a review of the literature concerning antibacterial treatment of bacteriuria in pregnancy. It is crucial to ensure that drugs to be used in pregnancy are safe and effective. Established first-line drugs such as ampicillin (pivampicillin) and amoxycillin, and other commonly used treatments such as trimethoprim-sulphamethoxazole, are associated with a high degree of resistance in Escherichia coli, the most common pathogen in the urinary tract. A recent survey of physicians in Denmark, Finland, Norway and Sweden confirms that beta-lactam antibiotics (particularly pivmecillinam) and nitrofurantoin are the drugs of first choice in the treatment of bacteriuria in pregnancy in the Nordic countries. No teratogenic effects have been associated with these agents. In contrast to nitrofurantoin, pivmecillinam is also efficient against pyelonephritis. In spite of resistance in E. coli and possible adverse effects on the fetus, many physicians still prescribe sulphonamides during the first two trimesters of pregnancy.
 ...
PMID:Which antibiotics are appropriate for treating bacteriuria in pregnancy? 1096 49

Bacteriuria in pregnancy, with or without clinical symptoms, is frequent. If left untreated, it can in 20-30% of cases lead to acute pyelonephritis, which is a serious threat to the mother and fetus, increasing the risk of preterm labour and low birthweight infants. This paper is a review of the literature concerning antibacterial treatment of bacteriuria in pregnancy. It is crucial to ensure that drugs to be used in pregnancy are safe and effective. Established first-line drugs such as ampicillin (pivampicillin) and amoxycillin, and other commonly used treatments such as trimethoprim-sulphamethoxazole, are associated with a high degree of resistance in Escherichia coli, the most common pathogen in the urinary tract. A recent survey of physicians in Denmark, Finland, Norway and Sweden confirms that beta-lactam antibiotics (particularly pivmecillinam) and nitrofurantoin are the drugs of first choice in the treatment of bacteriuria in pregnancy in the Nordic countries. No teratogenic effects have been associated with these agents. In contrast to nitrofurantoin, pivmecillinam is also efficient against pyelonephritis. In spite of resistance in E. coli and possible adverse effects on the fetus, many physicians still prescribe sulphonamides during the first two trimesters of pregnancy.
 ...
PMID:Which antibiotics are appropriate for treating bacteriuria in pregnancy? 1105 21

Bacteriuria in pregnancy with or without clinical symptoms is frequent and increases the risk of pyelonephritis, preterm labour, and low birth weight infants. Commonly used antibiotics such as ampicillin (pivampicillin), amoxicillin, trimethoprim, and sulphonamide are currently associated with a high degree of resistance of the most common pathogen in the urinary tract, Escherichia coli. During the past few decades a number of new and efficient antibacterial antibiotics have been developed. The presumption that a specific drug is safe for both the pregnant woman and the foetus depends on how widely the drug has been used. A recent survey among general practitioners and obstetricians in Denmark, Finland, Norway, and Sweden confirmed that the beta-lactam antibiotic pivmecillinam and nitrofurantoin are the most commonly used agents in the treatment of bacteriuria in pregnancy in the Nordic countries. However, a surprisingly high number of physicians reported that they prescribe sulphonamides during the first two trimesters in spite of resistance of E. coli and possible adverse effects on the foetus.
 ...
PMID:Use of antibiotics to treat bacteriuria of pregnancy in the Nordic countries. Which antibiotics are appropriate to treat bacteriuria of pregnancy? 1129 9

Urinary tract infections (UTI) in pregnant women are a relatively frequent occurrence and the spectrum of these infections ranges from lower urinary tract disease (asymptomatic bacteriuria, acute cystitis) to upper urinary tract disease (acute pyelonephritis). Anatomical and functional changes in the urinary tract in pregnancy result in significantly higher susceptibility to progression of the infection from asymptomatic bacteriuria to the stage of acute pyelonephritis. Untreated asymptomatic bacteriuria in pregnancy leads, in as much as 40%, to the development of acute pyelonephritis with all the subsequent negative effects not only for the woman herself, but particularly for the fetus. Bacteriuria in pregnancy accounts for a significantly higher number of newborns with a low birth weight, low gestational age and higher neonatal mortality rate. Therefore, it is necessary to perform screening for bacteriuria in pregnant women and, when the finding is positive, to treat this bacteriuria. The selection of an appropriate antimicrobial agent to treat urinary tract infection in pregnancy is limited by the safety of a given drug not only for the woman, but particularly for the fetus. The article provides an overview of medications that can be safely used throughout the pregnancy or only in certain stages of pregnancy. The selection of an appropriate antibiotic should always be preceded by the result of urine culture. The article presents the principles and rules for treating asymptomatic bacteriuria, acute cystitis and acute pyelonephritis in pregnant women.
 ...
PMID:[Urinary tract infections in pregnancy: when to treat, how to treat, and what to treat with]. 2270 77