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)

Optimal therapy for pyelonephritis requires the immediate administration of an effective broad-spectrum antibiotic. Because conventional oral antibiotics such as the sulfonamides and the aminopenicillins are limited by the development of resistant bacteria associated with this common disease, the therapeutic effectiveness of a new oral carbacephem antibiotic was investigated. Two double-blind, randomized clinical trials of loracarbef (LY163892) were conducted. A total of 245 patients (greater than or equal to 18 years old) with uncomplicated pyelonephritis were enrolled in parallel studies. One study compared loracarbef with cefaclor; the other compared loracarbef with norfloxacin. In the combined patient population, 119 patients were treated with loracarbef (400 mg twice daily), 43 with cefaclor (500 mg three times daily), and 83 with norfloxacin (400 mg twice daily). All treatment regimens continued for greater than or equal to 14 days. A total of 68 patients in the loracarbef group, 25 in the cefaclor group, and 43 in the norfloxacin group qualified for efficacy analysis. Escherichia coli was the causative pathogen in 85.0% of these patients. Successful posttherapy clinical and bacteriologic responses were similar for all three study drugs: 94.1 and 86.8%, 96.0 and 80.0%, 97.7 and 88.4% for loracarbef, cefaclor, and norfloxacin, respectively. Late posttherapy clinical responses were 87.4, 83.3, and 91.7% for the loracarbef, cefaclor, and norfloxacin groups, respectively. Bacteriologic responses for the three groups were 79.6, 60.0, and 88.9%. The most frequent adverse effects (headache, diarrhea, and nausea) were experienced by three patients (2.5%) in the loracarbef group; headaches were noted in two (4.7%) cefaclor patients, diarrhea was noted in three (7.0%) patients in the cefaclor group, and nausea was noted in four (9.3%). Gastrointestinal events were noted in four patients (4.8%) in the norfloxacin group. The data demonstrate that loracarbef is comparable in efficacy and safety to both cefaclor and norfloxacin as oral therapy for uncomplicated pyelonephritis.
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PMID:Loracarbef (LY163892) versus cefaclor and norfloxacin in the treatment of uncomplicated pyelonephritis. 162 52

In a prospective, open clinical study, 50 urological patients with acute pyelonephritis were treated with the oral cephalosporin cefixime. The medication (2 x 200 mg/day) was given for seven to ten days. Clinical, bacteriological as well as hematological examinations were carried out prior to, during and immediately after therapy. A late check-up was performed five to nine days after the end of therapy. 46 of the 50 cases were evaluable for efficacy, and all 50 patients were included in safety evaluation. The most frequent pathogens isolated prior to therapy were Escherichia coli (34 times), Proteus mirabilis (six times), Klebsiella pneumoniae (twice) and coagulase-negative staphylococci (twice). Immediately after the end of therapy the pathogens were eradicated in 44 (97.5%) patients. At the late check-up the urine was sterile in 29 (63%) patients. A relapse was observed in 11 patients, a reinfection in four and the initially isolated pathogens had persisted in two. Immediately after the end of therapy 44 (95.7%) patients were clinically cured and two patients had improved. At the late check-up 41 patients were classified as clinically cured, three showed improvement, and two improvement with relapse. Adverse reactions (one case nausea and exanthem, and one case of meteorism) occurred in two patients. No changes in the blood counts or in the liver and kidney functions were observed. In the study described here cefixime proved to be an effective and well tolerated antibiotic for the treatment of upper urinary tract infections; it is of particular interest that 16 of the 50 patients presented with underlying disease favoring infection.
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PMID:[Effectiveness and tolerance of cefixime in the treatment of acute pyelonephritis]. 207 74

We report the case of a 59-year-old diabetic woman with emphysematous pyelonephritis. The patient presented with nausea, vomiting, and right flank pain of three days duration. The diagnosis was established by a plain abdominal radiograph in the emergency department. Aggressive rehydration, control of diabetes, broad-spectrum antibiotic therapy, and early right nephrectomy resulted in rapid clinical improvement. Emphysematous pyelonephritis is rare and often fatal. Survival depends on early diagnosis and aggressive combined medical and surgical management.
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PMID:Emphysematous pyelonephritis: an emergency indication for the plain abdominal radiograph. 328 24

Ofloxacin, a new fluoroquinolone, was given to fifty patients (29 females and 21 males) aged 25 to 86 years with urinary tract infection or prostatitis. Urinary tract infections usually chronic and associated with urologic anomalies, included 17 cases of cystitis and 19 cases of pyelonephritis. 14 patients had prostatitis. Pathogens recovered from the urine were 26 E. coli, 2 Citrobacter, 4 Proteus mirabilis, 2 Klebsiella, 2 Enterobacter, 3 Serratia, 3 Staphylococcus aureus and 11 Pseudomonas. Minimal inhibitory concentrations of ofloxacin ranged from 0.03 to 0.12 microgram/ml (mean MIC: 0.6 microgram/ml) for 27 nalidixic acid-sensitive strains, and from 0.25 to 4 micrograms/ml (mean MIC: 1 microgram/ml) for 26 nalidixic acid-resistant strains. Ofloxacin was given as single drug therapy in all patients, in a daily dosage of 200 mg b.i.d. in 46 patients and 400 mg b.i.d. in 4 patients, for 7 to 97 days (average 40 days). Follow-up after discontinuation of treatment was 3 to 12 months. Therapeutic results were as follows: 17 cures for the 17 cystitis patients, 17 cures and 2 failures by relapse for the 19 cases of pyelonephritis, and 11 cures, 1 failure by persistence of bacteriuria and failure by relapse for the 14 cases of prostatitis. Digestive disorders, i.e. nausea, abdominal pain, constipation, occurred in 6 patients and required withdrawal of the drug in 1; candidiasis of the tongue was recorded in one patient and digestive complaints with neuropsychic disorders in another. Two patients had short-lived, moderate leukopenia with granulopenia and one had transient worsening of preexisting renal failure. Hepatic tolerance was good.
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PMID:[Ofloxacin (RU 43280): clinical evaluation in urinary and prostatic infections]. 353 29

The efficacy and safety of Timentin (ticarcillin plus potassium clavulanate) and piperacillin were compared in a clinical trial of 78 hospitalized patients with urinary tract infections. There were 37 evaluable patients in the Timentin-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 Timentin-treated group and four in the piperacillin-treated group also had septicaemia. Both ticarcillin (3 g) plus potassium clavulanate (200 mg) and piperacillin (125-200 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. Nine pathogens in the Timentin-treated group and 11 in the piperacillin-treated group were resistant to ticarcillin in vitro. Eradication was achieved for 39 of the 43 (91%) pathogens in the Timentin group, including all six organisms isolated from the blood, and eight (89%) of the ticarcillin-resistant pathogens. In the piperacillin-treated group, 33 of the 43 (77%) pathogens were eradicated, including three of the four blood isolates, but only eight (73%) of the ticarcillin-resistant pathogens. Clinical cure or improvement occurred in 97% of the patients in each group. Mild and transient increases in levels of liver enzymes or eosinophils were reported for 11 patients in the Timentin group and seven in the piperacillin group. In one patient in the Timentin group, a drug-related rash and nausea developed, and treatment was discontinued.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Timentin versus piperacillin in the treatment of hospitalized patients with urinary tract infections. 363 40

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

Clinical efficacy of Cefmetazole was evaluated at four university hospitals and their related hospitals in Nagoya. For the treatment of urinary tract infections with or without complications, 177 patients were administered Cefmetazole. Of these patients, 69 had chronic complicated urinary tract infection defined in the UTI manual and 20 had simple acute pyelonephritis. The other urological infections for which Cefmetazole was administered included prostatitis, epididymitis, urosepsis and wound infections. Fifty four patients were given Cefmetazole intravenously after urological operation to prevent wound and urinary tract infections. The overall clinical efficacy of Cefmetazole for UTI was 76.8%; 84.4% for group 1, 85.7% for group 3, 75% for group 4, 44.4% for group 5 and 66.6% for group 6. In acute pyelonephritis due to E. coli, Klebsiella, Serratia, S. aureus, alpha-Streptococcus and S. epidermidis all patients were cured by Cefmetazole administration. Clinical efficacy of Cefmetazole was assessed to be excellent in 6 cases of prostatitis and 6 cases of acute epididymitis. E. Coli, Serratia and some organisms disappeared from blood after the administration of Cefmetazole but Pseudomonas persisted even after treatment. Postoperative administration of Cefmetazole was effective for eradication of bacteria from the urine in 26 out of 30 patients and in prevention of infection in 24 cases. After the administration of Cefmetazole skin eruption was observed in one patient and nausea in another. Slight elevation of GOT, GPT and total bilirubin was noted in 3 of the 177 patients after medication.
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PMID:[Clinical evaluation of cefmetazole in urological infections]. 658 64

Clinical trials with KW-1062, a new aminoglycoside antibiotic, were carried out on the basis of the pre-clinical studies. Absorption and excretion of KW-1062 were studied in the healthy adults after single and multiple intramuscular administration. The blood concentration at single administration of 120 and 180 mg of KW-1062 reached the peak of 7 and 12 microgram/ml respectively 30 minutes after administration. The half life was constantly about 2 hours. The 10-hour urinary recovery rate was 55.6% and 60.8% at each of the above doses. No accumulation of KW-1062 in plasma was observed with multiple administration of 180 mg twice a day for 5 days. No adverse reactions (on blood, renal function and hearing) were observed. From these results, the dose of 360 mg/day period to be as safe as that of 240 mg/day. KW-1062 was administered to 155 patients at daily dose of 240 mg and 360 mg for 1 approximately 11 days. The cases collected and analyzed consisted of 105 patients with complicated U.T.I., 10 with acute and uncomplicated pyelonephritis, 16 with infection of neurogenic bladder after spinal cord injury and others. Of 105 patients with complicated U.T.I., 65 were administered KW-1062 at 360 mg daily, and 40 at 240 mg. KW-1062 was found to be effective in 52.5% of the 240 mg/day group, in 40% of the 360 mg/day group of complicated U.T.I., when evaluated on the basis of the criteria by the U.T.I. study group, and in 90% of patients with acute and uncomplicated pyelonephritis. Of 155 patients subjected to KW-1062 treatment, only one experienced tinnitus and nausea, and 17 had abnormal values in their laboratory findings.
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PMID:[Basic and clinical studies on KW-1062 at daily dose of 240 and 360 mg in the field of urology (author's transl)]. 699 37

The term biliary pseudolithiasis was coined by Schaad (1988) to describe the appearance of gallbladder sludge following treatment with ceftriaxone. After cessation of the drug the condition resolves, hence the term "pseudolithiasis." The third generation cephalosporin, cefatriaxone, is a very potent, broad spectrum antibiotic indicated in meningitis, osteomyelitis, pyelonephritis, Lyme disease and many other severe infectious diseases. Up to 46% of those receiving this antibiotic develop gallbladder sludge. Most are asymptomatic, but a small proportion may develop right upper quadrant pain, nausea, vomiting and even cholecystitis. Ultrasonography may demonstrate many, small, echogenic particles within the gallbladder, as well as larger echogenic foci casting acoustic shadows. However, it can not differentiate these pseudostones from real stones. There are reports of surgical intervention in such cases. 2 boys, aged 5 and 10 years, respectively, treated with ceftriaxone for meningitis are presented. Both developed symptoms during treatment and in both gallbladder sludge was identified by ultrasonography. In 1 intraluminal gallbladder findings were identical with the appearance of surgical stones. Follow-up ultrasonography after the drug was stopped showed no evidence of pseudostones in either case. Awareness of this phenomena might save many unnecessary operations.
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PMID:[Sonographic demonstration of pseudo-cholelithiasis after ceftriaxone]. 799 84

Pefloxacin (Abaktal) was used in treatment of 83 patients: 14 patients with acute pyelonephritis, 5 patients with carbuncle of the kidney, 17 patients with postoperative acute pyelonephritis, 3 patients with urosepsis, 7 patients with acute prostatitis, 18 patients with chronic pyelonephritis in the phase of active inflammation, 9 patients with exacerbation of chronic prostatitis, 3 patients with acute cystitis, 2 patients with acute urethritis and 5 patients with epididymo-orchitis. Two dosage forms of pefloxacin were used i.e. tablets of 400 mg and ampoules of 5 ml containing 400 mg of the active substance. The treatment course amounted to 7-14 days. In the patients with inflammatory infectious diseases of the lower urinary tracts (cystitis and urethritis) the treatment course amounted up to 5 days. The results of the treatment with the ampoule solutions were good and satisfactory. With the use of the tablets the results were unsatisfactory in 3 patients (8.1 per cent). Satisfactory bacteriological efficacy of the treatment was stated in 89.5 per cent of the cases. The adverse reactions such as nausea, vomiting, diarrhea and skin eruption were recorded in 5 patients (6 per cent).
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PMID:[Clinical effectiveness of pefloxacin (abaktal)in the treatment of inflammatory diseases of the kidneys, urinary tracts and genital organs]. 807 66


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