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)

A 63 year old male underwent cystectomy and ureterosigmoidostomy after diffuse carcinoma "in situ" of the bladder was discovered, and thereafter, various episodes of pyelonephritis and metabolic imbalance, in one of them, a left pneumo-ureter and a positive blood culture for Clostridium Perfringens and enterococci was detected. Empiric therapy with Aztreonam was started, and changed after to high-dose intravenous amoxicillin. Two months later the ureterosigmoidostomy was converted to an ileal conduit. The patient has remained asymptomatic on subsequent controls.
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PMID:[Bacteremia caused by Clostridium perfringens as a complication of ureterosigmoidostomy]. 163 62

The in vitro activity, pharmacokinetics, bactericidal activity, and tissue penetration of aztreonam suggest that it may play a role in therapy for serious gram-negative bacterial infections in children. Several thousand children throughout the world received aztreonam during open or comparative clinical trials for treatment of infections including pyelonephritis, bacteremia, meningitis, skeletal infection, pneumonia, and peritonitis. Cure rates have ranged from 92% to 100%, with relapses seen mainly in children with obstructive renal lesions and those with infections caused by Salmonella. A comparative trial of aztreonam for treatment of neonatal sepsis showed it to be at least as effective as amikacin for this infection. Aztreonam yielded clinical results comparable to those of conventional combined therapy for pulmonary infection in patients with cystic fibrosis. Adverse effects in pediatric trials have been uncommon; fever, diarrhea, or rash occurred in less than 2% of treated children. Reversible laboratory abnormalities have occasionally been noted. On the basis of these data, aztreonam is considered an appropriate alternative agent for the treatment of serious gram-negative bacterial infections in neonates and children. Further comparative clinical trials will delineate specific indications.
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PMID:Clinical experience with aztreonam for treatment of infections in children. 206 62

Eighty-two evaluable patients suffering from UTI were randomly treated with parenteral Aztreonam (1 g OD in cystitis and 1 g BID in pyelonephritis) or oral Norfloxacin (400 mg BID). Predisposing urological conditions were present in 75% and 78.5% respectively. Microbiological cultures at the end of treatment and at a follow-up visit after 4 weeks showed significantly better results among Aztreonam treated patients (microbiological cure: 97.5% vs 71.4%-p less than or equal to 0.005). Clinical cure was achieved in 97.5% and 71.4% respectively (p less than or equal to 0.001). A statistically significant difference was present only in patients treated for pyelonephritis (microbiological cure-AZT: 100%; NOR: 50%-p less than or equal to 0.0005) and not in those with cystitis (AZT: 95.0%; NOR: 83.3%). Side effects were rare in both treatments. Aztreonam seems to offer major advantages, when compared to Norfloxacin, in the treatment of UTI, especially when upper urinary tract is involved.
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PMID:[Aztreonam vs norfloxacin: a comparative study of the treatment of urinary tract infections in ambulatory and hospitalized patients]. 252 96

Twenty nine patients of an intensive care unit (9 women and 20 men), aged 63.9 +/- 15.8 years, with a mean body weight of 62.5 +/- 11.8 kg were treated during 9.4 +/- 2.1 days by aztreonam (2 x 1 g/24 h) administered by short infusion (30 min) for a severe infection due to a Gram-negative bacilli. The primary (n = 25) or nosocomial (n = 4) infection sites were a peritonitis (14), a septicaemia (6), a cholecystitis (6), a pyelonephritis (5), a cholangitis (2), a subphrenic abscess (1) or a pneumonia (2). The isolated Gram-negative bacilli were all susceptible to aztreonam, their MIC being less than or equal to 0.5 micrograms/ml, except for a Pseudomonas aeruginosa (MIC = 4 micrograms/ml). Aztreonam was administered as a single therapy to 7 patients and in association with metronidazole (18) and/or penicillin G (14) to 22 patients; in fact, anaerobes were isolated in ten patients. The mean serum concentrations of aztreonam, as measured by HPLC, before and after the 7th administration respectively were 83.2 +/- 17.5 and 6.1 +/- 5.5 micrograms/ml for peak and through levels. The treatment of the 29 infections was a success in all the cases. No complication occurred due to the presence of Gram positive cocci (n = 4) in the first bacteriological sample, or due to the emergence (n = 12) of Gram positive cocci, except for one case of sepsis of the abdominal wall by Staphylococcus aureus. Aztreonam (2 x 1 g/24 h) may be a suitable alternative for the treatment of severe infections of intensive care units, mostly due to Gram-negative bacilli.
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PMID:[Aztreonam treatment of severe infections caused by gram-negative aerobic bacilli]. 304 52

Aztreonam (AZT) was evaluated for its clinical efficacy in a total of 10 cases, namely 3 cases of endometritis, 6 cases of intrapelvic infections, 1 case of puerperal pyelonephritis. The clinical results of AZT were as follows; excellent in 5 cases and moderate in 5 cases, the overall efficacy rate was 100%. No clinical side effect was observed, however in laboratory finding slightly elevated transaminase (GOT, GPT) was observed in 1 case.
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PMID:[Clinical evaluation of aztreonam in the field of obstetrics and gynecology]. 383 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

Aztreonam (SQ 26,776) is the first parenteral monobactam agent to be used in patient trials. The agent has significant activity in vitro against facultative aerobic gram-negative bacteria but not against gram-positive or anaerobic bacteria. Aztreonam was used for a year to treat 106 hospitalized patients with a total of 131 documented gram-negative infections. Important exclusion criteria included granulocytopenia, hyperbilirubinemia, meningitis, patients less than 13 years of age, pregnancy, and history of anaphylaxis to penicillin. In this study of 35 men and 71 women, there were 67 cases of pyelonephritis (25% bacteremic), 19 of pneumonia (16% bacteremic), 10 of skin or soft-tissue infections, 9 cases of osteomyelitis, and 6 cases of postpartum endometritis. During the study period, 159 facultative aerobic gram-negative bacteria were tested for aztreonam susceptibility, and 144 (91%) were found to be susceptible. Eighty percent of infections were cured by both clinical and microbiological criteria and each of the other 26 infections showed clinical improvement. Eradication of the infecting organism was achieved in 89% of infections without adverse reaction or drug toxicity.
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PMID:Treatment of serious gram-negative infections with aztreonam. 654 72