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)

Bacteriological and clinical evaluations of BRL 25000 (1 part clavulanic acid plus 2 parts amoxicillin) granules in the pediatric field have been performed. The MICs of BRL 25000 against 25 clinically isolated strains of S. aureus, 40 E. coli, and 14 K. pneumoniae were compared with those of AMPC. Against beta-lactamase non-producing strains of S. aureus and E. coli, the MICs of both drugs were nearly equal, however, against beta-lactamase producing strains of these species and K. pneumoniae, BRL 25000 was superior to AMPC. The blood levels of AMPC and CVA after single oral administration of approximately 15 mg/kg of BRL 25000 granules to fasted children were studied in 3 subjects. The mean levels of AMPC and CVA peaked about 1 hour after administration at values of 11.40 and 5.49 micrograms/ml, respectively, with half-lives of 0.91 and 1.02 hours, and AUCs of 23.52 and 12.66 hr X micrograms/ml, respectively. The 6-hour urinary recovery of AMPC ranged from 30.59% to 52.03% and for CVA from 16.31% to 45.18%. There was no significant difference between the blood level of AMPC following single oral administration of approximately 10 mg/kg AMPC granules and that of AMPC following single oral administration of approximately 15 mg/kg BRL 25000 granules to the same children. Clinical evaluation of BRL 25000 granules administered orally 3-4 times a day at total daily doses of between 42.9-52.9 mg/kg resulted in improvement, judged excellent or good, in all 7 cases of tonsillitis and 2 cases of pyelonephritis. In particular, the clinical effect was excellent in the case of tonsillitis where a beta-lactamase producing H. influenzae was isolated. In the total 11 cases treated, including 2 cases of mycoplasmal pneumonia excluded from the clinical evaluation, 1 case of rash and eosinophilia was observed. No other adverse reactions or abnormal laboratory findings were observed. The taste and flavor of the drug were well accepted by the children. It was concluded that BRL 25000 granules are promising new drug which should be markedly useful in the treatment of infections in pediatric outpatients.
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PMID:[Bacteriological and clinical evaluation of BRL 25000 (clavulanic acid-amoxicillin) granules in the pediatric field]. 384 23

Microbiological, pharmacokinetic and clinical studies on sulbactam/cefoperazone (SBT/CPZ) were carried out in the field of pediatrics. Antimicrobial activity The MIC80 of SBT/CPZ was 6.25 micrograms/ml for clinically isolated 24 strains of S. aureus (24 beta-lactamase producing strains), 0.39 micrograms/ml for 17 strains of S. pyogenes, 3.13 micrograms/ml for 24 strains of E. coli (22 beta-lactamase producing strains), 3.13 micrograms/ml for 22 strains of K. pneumoniae (22 beta-lactamase producing strains), 1.56 micrograms/ml for 22 strains of P. mirabilis and 0.20 microgram/ml for 15 strains of H. influenzae (13 beta-lactamase producing strains). In comparison with CPZ in respect to the MIC, SBT/CPZ exhibited synergistic effect on 31 strains out of 81 beta-lactamase producing strains (included 6 strains of S. aureus, 9 of E. coli, 5 of K. pneumoniae and 11 of H. influenzae) which was scarcely observed against 43 non-beta-lactamase producing strains. Absorption and excretion Serum levels and urinary excretion of SBT/CPZ were studied in 7 children aged 5 to 12 years. The mean serum concentration of SBT at 15 minutes following a single intravenous injection of 10 mg/kg of SBT/CPZ was 14.2 micrograms/ml and that of CPZ was 30.4 micrograms/ml. The mean urinary recovery rates at 6 hours following the intravenous injection were 57.8% and 18.3%, respectively. The mean serum concentrations of SBT and CPZ after 1-hour infusion of 10 mg/kg of SBT/CPZ were 10.9 micrograms/ml and 17.6 micrograms/ml, respectively. The urinary recovery rates of SBT and CPZ at 7 hours after the infusion were 100.0% and 27.7% on average, respectively. The mean serum levels of SBT and CPZ at 15 minutes after a single intravenous injection of 20 mg/kg of SBT/CPZ were 25.6 micrograms/ml and 66.0 micrograms/ml, respectively and urinary elimination until up to 6 hours were 72.5% on average for SBT and 21.1% for CPZ. Clinical study SBT/CPZ was used for the treatment of a total of 20 pediatric patients aged 1 month to 14 years to evaluate its clinical effectiveness, bacteriological efficacy and adverse effects. The clinical efficacy in 6 patients with acute pneumonia, 3 with staphylococcal scalded skin syndrome, 2 each with acute purulent tonsillitis and acute pyelonephritis, 1 each with acute purulent lymphadenitis, acute sinusitis, acute bronchitis, peritonitis and acute enteritis was judged to be excellent in 15 cases and good in 3 cases with an efficacy ratio of 100%. The clinical efficacy in 6 patients whose infections were caused by beta-lactamase producing strains was judged to be excellent in all the cases.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Studies on sulbactam/cefoperazone in the field of pediatrics]. 609 65

Hemophilus influenzae has rarely been reported to cause urinary tract infections, but media supportive of its growth are not routinely used for urine cultures. At two Veterans Administration medical centers, H influenzae was isolated from the urine of eight men in the past four years. All had anatomic or functional genitourinary abnormalities, and half had had chronic pyelonephritis or recurrent urinary tract infections. Three patients had acute cystitis, two patients had pyelonephritis, two patients had prostatitis, and one patient had asymptomatic bacteriuria with pyuria. Cases were discovered by primary isolation on chocolate agar or sheep's blood agar, by "satelliting" around staphylococci, or by positive urine Gram's stains. Urine Gram's stains disclosed organisms in all six nonprostatitis cases. Organisms were all nonserotypable, were of biotypes 2, 3, or 4, and were beta-lactamase negative. Hemophilus influenzae may be a more common uropathogen in adults than previously recognized.
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PMID:Hemophilus influenzae as a cause of urinary tract infections in men. 633 7

Ceftazidime, a new beta-lactamase resistant aminothiazo-oyl cephalosporin with a broad spectrum of antibacterial activity against gram-positive and gram-negative bacteria, including Pseudomonas species, was evaluated clinically for efficacy and safety at 3 dosage levels in patients with acute genitourinary tract infection. Sixty patients with infections, including cystitis, pyelonephritis, epididymitis and prostatitis, were assigned randomly to 1 of the 3 dosage regimens: 250, 500 or 1,000 mg. administered intramuscularly every 12 hours. Patients were evaluated bacteriologically and clinically during the course of treatment and after treatment. All patients became asymptomatic and showed clinical improvement or cure within 48 to 72 hours regardless of dosage. Bacteriological success, namely eradication of the pathogen during therapy with no recurrence of superinfection during followup, was attained in 95 per cent of the patients with uncomplicated infections and in 61 per cent of those with complicated infections. Superinfections accounted for most of the noncures, particularly with the 250 mg. regimen. The difference in success rates between the 250 mg. dosage, and the 500 mg. and 1 gm. dosages in patients with complicated infections was statistically significant. Injections were well tolerated without significant side effects. No clinically important variations in laboratory tests were observed. The results indicate that ceftazidime is a useful third generation cephalosporin for complicated and uncomplicated genitourinary infections but it is recommended that the 250 mg. dosage not be used in patients with complicated infections.
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PMID:Ceftazidime, an open randomized comparison of 3 dosages for genitourinary infections. 635 Jun 16

The authors undertake a general review of recent advances in the field of urinary tract infections. Attention is drawn to the fact that bacteria can proliferate only if they adhere to the wall of the urinary tract before penetrating the epithelial cells. This adhesion is dependent upon adhesins which, in the urinary tract, can fix only upon specific receptors. It can therefore be understood that a mucosa bearing many receptors can easily by reinfected with organisms with the intestinal flora as their point of departure, via perineal and peri-urethral meatal infestation in the woman. A recent therapeutic advance is based upon the use of beta-lactamase inhibitors. A beta-lactamine neutralises the beta-lactamase produced by the organism and the other beta-lactamine acts as an antibiotic and kills the organism. This combination of two lactamines will probably be increasingly widely used in dealing with organisms. It is important to note that bacteriologists draw attention to the need to detect congenital abnormalities or foreign bodies or neighbouring infections, before incriminating only problems of bacterial virulence and the abnormally abundant presence of receptors on the urethrovesical mucosa. In the absence of urological disease, the treatment of lower urinary tract infections in the woman is not based upon any particular rules since short-term treatment seems just as effective as long-term treatment. The problem is completely different in the treatment of acute pyelonephritis which requires a minimum of three weeks using an antibiotic with powerful tissue diffusion.
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PMID:[Medical aspects of urinary tract infections]. 635 5

Ro 13-9904, a new broad-spectrum, beta-lactamase-resistant, cephalosporin, was given as a single i.m. injection at doses of 500, 250, and 125 mg in 3 groups of male patients each consisting of 10, 6, and 6 patients respectively, suffering from uncomplicated acute but recurrent gonococcal urethritis. All patients were cured both clinically and bacteriologically without relapsing after a 7-day follow-up. 11 patients suffering from chronic urinary tract infections without flow obstruction but with underlying chronic pyelonephritis in 6, were treated for 7 days with 500 mg of Ro 13-9904 i.m., every 12 h. E. coli and P. mirabilis were the main isolated pathogens. Treatment was successful in all with only one bacteriological relapse during the follow-up period. The drug's tolerance was satisfactory except for moderate local pain in most of the patients.
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PMID:Antibacterial activity of Ro 13-9904 and preliminary experience in gonorrhoea and chronic urinary tract infections. 701 52

The therapeutic effects produced by formulations of amoxicillin plus clavulanic acid (BRL 25 000A and BRL 25 000G) were compared with those of amoxicillin and clavulanic acid separately against a variety of infections produced by amoxicillin-susceptible and beta-lactamase-producing (amoxicillin-resistant) bacteria. The infection models studied included intraperitoneal infections, a mouse pneumonia, experimental pyelonephritis, and local lesions caused by Staphylococcus aureus and Bacteroides fragilis. The distribution of amoxicillin and clavulanic acid in infected animals after the administration of amoxicillin-clavulanic acid was evaluated by measurement of the concentrations of the substances present in specimens collected at the sites of infection. The results showed that both amoxicillin and clavulanic acid were well distributed in the animal body after the administration of amoxicillin-clavulanic acid formulations, being present in significant concentrations at various sites of infection, e.g., peritoneal washings, pleural fluid, pus, and infected tissue homogenates. In a number of cases, the amoxicillin concentrations measured after the administration of BRL 25000 were higher than those found after treatment with amoxicillin alone, presumably as a result of inhibition of bacterial beta-lactamases by clavulanic acid at the site of infection. The ability of clavulanic acid to protect amoxicillin in vivo was confirmed by the efficacy of amoxicillin-clavulanic acid formulations in the treatment of the infections studied, most of which were refractory to therapy with amoxicillin.
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PMID:Distribution of amoxicillin and clavulanic acid in infected animals and efficacy against experimental infections. 713 80

Augpenin contains ticarcillin (TIPC) and clavulanic acid (CVA), at a ratio of 15:1. The beta-lactamase inhibitor, CVA, has been added to protect the TIPC from inactivation by beta-lactamase. To investigate the drug efficacy and safety against urinary tract infections (UTI), Augpenin was administered to 33 patients with chronic complicated UTI and 7 patients with acute pyelonephritis. Thirty two cases were evaluable by the UTI criteria. Excellent results were obtained in 6 of the cases of acute pyelonephritis, and moderate results in 1 case, with an overall effectiveness rate of 100%. Excellent results were obtained in 14 of the cases of chronic complicated UTI, moderate results in 9 cases, and poor results in 2 cases, with an overall effectiveness rate of 92%. No adverse reactions were noted, but a transient elevation of glutamic oxaloacetic transaminase and glutamic pyruvic transaminase levels was observed in 2 cases.
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PMID:[Clinical evaluation of Augpenin (clavulanic acid-ticarcillin) in urinary tract infections: especially against beta-lactamase producing strains]. 837 83

Toxic shock syndrome (TSS) is caussed by toxic shock syndrome toxin-1 (TSST-1) of Staphylococcus aureus. We studied the incidence of TSST-1 production by the clinical isolates of S. aureus, in order to clarify the possibility of TSS caused by S. aureus. One hundred and seventeen clinical isolates of S. aureus were tested. Of 117 strains, 74 were methicillin-cephem resistant S. aureus (MRSA), and 43 were methicillin-cephem sensitive S. aureus (MSSA). TSST-1 production and penicillinase (PCase) activity were measured by means of reversed passive Latex aggulutination method and acidmetric assay, respectively. The incidences of TSST-1 production by PCase positive MRSA, PCase negative MRSA, PCase positive MSSA and PCase negative MSSA were 92% (55/60), 78% (11/14), 21% (7/33) and 0% (0/10), respectively. TSS occurred in a patient with chronic complicated pyelonephritis after endopyelotomy for hydronephrosis. In this patient, PCase positive MRSA which produced TSST-1 was isolated from urinary tract, and he was cured after administration of arbekacin. These results indicsate that methicillin-cephem resistance and PCase production are the risk factors for TSST-1 production in S. aureus.
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PMID:[Correlation in Staphylococcus aureus infections between toxic shock syndrome toxin-1 production and clinical feature]. 969 69

We report the clinical courses of 3 patients with urinary obstruction who developed acute pyelonephritis caused by multidrug-resistant (MDR) Pseudomonas aeruginosa. Genome fingerprinting was performed to clarify the route of cross-infection, and an imipenem-resistance gene was detected by the polymerase chain reaction (PCR) method. The study included 17 patients at our institute who had urinary tract infections caused by P. aeruginosa between January and December 1997. MDR was defined as that when all the minimum inhibitory concentrations (MICs) were determined to show resistance according to the breakpoints recommended by the National Committee for Clinical Laboratory Standards (NCCLS) for P. aeruginosa. Pulse-field gel electrophoresis (PFGE) was carried out for genome fingerprinting. PCR was used to detect the metallo-beta-lactamase gene ( bla(IMP)). Three strains were revealed for MDR. The strains were isolated from the 3 patients with urinary tract obstruction who developed acute pyelonephritis. The treatment consisted of urinary drainage for the obstructed urinary tract and parenterally administered antimicrobials. Although none of the strains was susceptible to any antimicrobials, all patients had favorable outcomes. PFGE revealed that two strains had an identical genotype, implying cross-infection between the patients. The bla(IMP) gene was not detected in any of the three strains. In febrile patients with urinary tract infection caused by MDR P. aeruginosa, treatment for urinary obstruction is strongly recommended. Initial empirical chemotherapy with antimicrobials to which the organism is not susceptible is often inevitable. Because there was epidemiological evidence of cross-infection with MDR P. aeruginosa, countermeasures against nosocominal infection are warranted.
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PMID:Multidrug-resistant Pseudomonas aeruginosa isolated from the urine of patients with urinary tract infection. 1195 21


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