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 previously healthy 2.5-year-old boy developed symptoms of acute pyelonephritis following an acute gastroenteritis. The patient received parenteral ampicillin and gentamicin for 72 hours and then ampicillin for an additional 11 days when the original urine and stool cultures grew Salmonella enteritidis, sensitive to ampicillin. The patient responded very well to treatment, but B-mode renal ultrasonogram revealed a left hydronephrosis and megaureter suggestive of longstanding obstruction of the ureterovesicular junction, later confirmed by other diagnostic studies and by surgical exploration and repair. Salmonella infection has been rarely documented to cause pyelonephritis in children. Obstructive uropathy appears to be a predisposing factor for this unusual complication of Salmonella enteritis.
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PMID:Salmonella enteritidis. A rare cause of pyelonephritis in children. 351 8

96 patients with clinical symptoms of acute pyelonephritis were randomized to 2 weeks treatment with either a fixed combination of pivampicillin and pivmecillinam or to pivampicillin alone. If needed, treatment was first started with the respective parenteral equivalents of the drugs. Acute pyelonephritis was bacteriologically verified in 57 patients, in whom Escherichia coli was isolated in 80% of the cases, Klebsiella in 7% and Proteus mirabilis in 5%. 22 of the 39 patients excluded did not have significant bacteriuria (less than 10(8) c.f.u./l). Combination treatment was superior to pivampicillin/ampicillin alone, in terms of clinical effect, with successful treatment being noted in 93% in the combination group and in 53% in the ampicillin group (p = 0.002). The combination was also more effective bacteriologically and it did not select resistant strains in the urinary tract. Ampicillin treatment alone, was, however, associated with a significant increase in urinary strains resistant to ampicillin and to mecillinam. Unsuccessful responders had a significantly higher mean age (p less than 0.01) than successful responders. No serious side-effects were noted.
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PMID:The combination of pivampicillin and pivmecillinam versus pivampicillin alone in the treatment of acute pyelonephritis. 353 49

The importance of high intrarenal levels of gentamicin on the outcome of experimental pyelonephritis was studied in rats receiving either a short course (three days) of gentamicin (G) alone or combined with a longer course (14 days) of ampicillin (A), cephalothin (C), or trimethoprim (T), or two weeks of therapy with ampicillin, cephalothin, trimethoprim and gentamicin given alone. While ampicillin, cephalothin and trimethoprim were undetectable in the medulla within six hours of cessation of therapy, gentamicin was still detectable in levels six folds above the MIC up to six months after treatment had ceased. Six months after the end of treatment, the percentage of sterile left kidneys in animals treated with ampicillin (50%), cephalothin (15%), trimethoprim (20%) was lower than the percentage of animals receiving 14 days of gentamicin (100%), or the combinations AG:89%, CG:67% and TG:60%, P less than 0.01. Following three days of gentamicin, 50% of the left kidneys were sterilized. When compared to ampicillin, cephalothin or trimethoprim alone, combined therapies significantly reduced the number of CFU in the kidneys P less than 0.01. These combinations were almost as effective as two weeks of therapy with gentamicin. Short-term therapy (three days) with an aminoglycoside which concentrates in the renal parenchyma, combined with an antibiotic which will accumulate in other parts of the nephron, may result in "pharmacological synergy". This new approach to therapy of pyelonephritis may be promising.
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PMID:Benefit from high intrarenal levels of gentamicin in the treatment of E. coli pyelonephritis. 353 52

Temocillin is a beta-lactamase-stable penicillin with a selective. Gram-negative spectrum of activity and a long half-life. Previous studies in adult patients have demonstrated its efficacy and safety in the treatment of Gram-negative infections. The aim of the study was to evaluate the clinical and bacteriological efficacy and safety of temocillin in children with complicated urinary tract infections. Twenty-two children, aged 3 months to 13 years (mean 5.8 years) were treated with temocillin i.v. at a dose of 25 mg/kg 12 hourly for a mean period of 5.9 days (range 3-12 days). Acute pyelonephritis was diagnosed in 21 patients (one case associated with septicaemia); one patient presented recurrent bacteriuria due to a multiresistant pathogen. Some 20/22 children presented an underlying condition complicating the urinary tract infection (UTl). The causative pathogens, isolated from the urine, were: E. coli (17), Proteus mirabilis (3), Enterobacter cloacae (1), enterococcus (1). The enterococcus and one Proteus mirabilis were found to be resistant to temocillin. Clinical improvement was obtained after 24-36 h in all children with temocillin-sensitive organisms. Bacteriological cure was obtained in all patients with temocillin-sensitive organisms. The two patients with temocillin-resistant pathogens were treated with another antibiotic. Follow-up treatment was given per os during +/- 2 weeks. No adverse reactions or abnormal laboratory values were noted. In the authors' limited experience temocillin proved to be effective and safe in the treatment of pyelonephritis often due to ampicillin-resistant strains in children.
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PMID:Temocillin in the treatment of pyelonephritis in children. 362 46

In a racially mixed community in Gisborne, New Zealand, the prevalence of asymptomatic (covert) bacteriuria of pregnancy was 9.6%. The prevalence in Maori women was 17.1% and in non-Maori women 4.7%. There was a higher prevalence of bacteriuria in the younger women. Escherichia coli was the infecting organism in 58 of the 72 women with bacteriuria. Twenty-five (44%) of the E. coli were resistant to ampicillin and amoxycillin. Fifty-eight (81%) of the women with bacteriuria also had pyuria. In 37 of the 44 women (84%) who received antimicrobial therapy, the infection was cured. Single dose therapy was just as effective as a course of treatment. In 14 of the 28 untreated women, the infection cleared spontaneously. Four of the 28 (14%) patients in the untreated bacteriuric group developed acute pyelonephritis. More patients with bacteriuria had anaemia and a low fetal birth-weight.
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PMID:Bacteriuria in pregnancy. 391 15

The combined enzymological investigation including determination of the total activity of asparagine transaminase and alanine transaminase, two serum enzymes, alkaline phosphatase, gamma-glutamyl transpeptidase, acetyl cholinesterase, and butyryl cholinesterase was applied to two groups of pregnant women with pyelonephritis treated with ampicillin (12 patients) and roscillin (14 patients). The investigation was performed at the following stages: before the treatment, on the 7th and on the 12th day of the treatment. No statistically significant differences in the average values of the activity of the above enzymes at these stages were observed in patients of the both groups which indicated the absence of the hepatotoxic effect of the preparations on the patients of a group as a whole. An increase in the levels of transaminases recorded in some patients after discontinuation of the treatment course was evident of a possible cytotoxic effect of the drugs without the signs of cholestasis. The effect was connected with the initial functional renal insufficiency.
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PMID:[Enzymological evaluation of the hepatotoxicity of ampicillin and its therapeutic form, roscillin, in the treatment of pyelonephritis in pregnancy]. 399 43

The pharmacokinetics of ampicillin was studied in 38 patients with acute pyelonephritis in the second and third trimesters of pregnancy after the first and the last (28th-32nd) intramuscular injections of the antibiotic. The ampicillin levels in the blood and urine were determined with the agar diffusion method. The pharmacokinetic parameters were estimated in a one-compartmental model by computer The ampicillin levels in the blood and urine of the patients did not practically differ at all the investigation periods (0.5-6 hours after the antibiotic administration) in the second and third trimesters of pregnancy. During the treatment, the rate of ampicillin elimination from the host increased and the period of half-elimination from the blood decreased. The antibiotic levels in the urine within 4-6 hours after the last injection were practically lower in the second trimester of pregnancy as compared with the second trimester. The therapy resulted in an increase in the antibiotic renal clearance, which returned to normal in the second trimester of pregnancy and remained under normal in the third trimester of pregnancy. The increase was due to an approximately 2-fold acceleration of the rate of ampicillin secretion by the renal tubules. The total clearance of ampicillin practically increased in the second trimester of pregnancy and remained decreased in the third trimester of pregnancy. The estimation performed in accordance with the Krueger-Timmer principles on the basis of the characteristic features of the pharmacokinetics of ampicillin shown in the study provides recommendation of the following scheme for pyelonephritis treatment in pregnant women: 500 mg of ampicillin injected intramuscularly every 6 hours followed by gradual decreasing of the intervals between the injections to 4 hours as the rate of ampicillin elimination increases.
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PMID:[Ampicillin pharmacokinetics in pregnant women with acute pyelonephritis]. 401 63

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

Technical and maternal factors known to affect urinary estriol level or its measurement are discussed in view of the current use of serial estriol as an indicator of fetoplacental function. Technical artifacts can result from presence of methenamine mandelate, phenolphthalein, glucose, or high urine specific gravity. Aside from normal maternal factors such as inaccurate urine collection or variable fluid intake, estriol levels are depressed by corticosteroids and ampicillin. Pyelone phritis, anemia, hemoglobinopathy, abnormal renal status, malnutrition, and high altitude all depress estriol level or excretion. In some conditions such as pyelonephritis, amniotic estriol level may be a better indicator of fetal status.
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PMID:Factors affecting the yeild of urinary estriol. 433 82

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


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