Treatment Of Acute Urinary Infections Research Articles

Nitrofurantoin: properties and potential in treatment of urinary tract infection: a narrative review.

Nitrofurantoin (NF), a wide-spectrum antibiotic accessible since 1953, is utilized widely to treat urinary tract infections as it usually stays active against drug-resistant uropathogen. The use of Nitrofurantoin has increased exponentially since new guidelines have repositioned it as first-line therapy for uncomplicated lower urinary tract infection (UTI). To, although fluoroquinolones are usually used to re-evaluate the first- and second-line therapies for treating uncomplicated UTI, their level of utilization is thought to be inappropriately excessive and will eventually have a detrimental impact; thus, we hypothesize that NF might be the best choice for this condition, because of its low frequency of utilization and its high susceptibility in common UTI pathogens. It can be concluded from this review that NF can be considered as the most effective drug in the treatment of acute urinary infection, but due to the long-term side effects of this drug, especially in elderly patients, it is essential to introduce some criteria for prescribing NF in cases of chronic UTI.

Cynanchi atrati and Its Phenolic Constituent Sinapic Acid Target Regulator of Calcineurin 1 (RCAN1) to Control Skin Inflammation.

Atopic dermatitis (AD) is a common inflammatory skin disorder, and numerous pharmacological approaches are employed to reduce symptoms. Natural products of plant-derived materials have been accepted as complementary therapy for the treatment of a wide range of inflammatory diseases. Cynanchi atrati (CA) is an oriental medicinal herb used in the treatment of acute urinary infection, febrile diseases, and laryngopharyngitis. However, the role of CA root extract in skin inflammation such as AD has not been explored yet. In this study, we examined the possible effect of CA root extract on skin inflammation and evaluated the underlying signaling mechanism using in vitro and in vivo modeling systems. Raw264.7 macrophages were used for in vitro experiments, and an oxazolone-induced AD mouse model was used to evaluate in vivo effects. CA extract significantly inhibited the expression levels of lipopolysaccharide (LPS)-induced pro-inflammatory cytokines such as interleukin-6 (IL-6) and interleukin-1β (IL-1β) in RAW264.7 macrophages. The CA root extract mediated suppression of pro-inflammatory cytokine expression and was associated with the decreased nuclear factor kappa B (NF-κB) gene transcriptional activation. Moreover, CA root extract attenuated the in vivo expression of IL-6 and tumor necrosis factor-α (TNF-α) and ear swelling in the AD mouse models. We also observed that the inhibitory effect of CA root extract on skin inflammation was accompanied by the upregulation of calcineurin 1 (RCAN1) expression, which functions in the inflammatory pathways by suppressing NF-κB signaling. We consistently observed that the immunosuppressive effect of CA root extract in AD was significantly perturbed in the RCAN1 knockout mice. In addition, we isolated a phenolic acid compound, sinapic acid (SA), from the CA root extract and found that SA consistently exerted an immunosuppressive effect in RAW264.7 macrophages by inducing RCAN1 expression. Our results provide the first evidence that CA root extract and its phenolic acid constituent, SA, modulate NF-κB signaling pathways by inducing RCAN1 expression in the skin inflammation process. Thus, we suggest that CA root extract has a therapeutic value for the treatment of AD by targeting endogenous immune regulators.

Antibiotic-Associated Hemorrhagic Colitis Caused by Cytotoxin-Producing Klebsiella oxytoca

Klebsiella oxytoca was recently described as the causative organism for antibiotic-associated hemorrhagic colitis (AAHC). It is currently not known if this novel gastrointestinal infection exists in children. AAHC is usually preceded by antibiotic treatment with penicillins, which are frequently prescribed for pediatric patients. In contrast to colitis caused by Clostridium difficile, colitis caused by K oxytoca is usually segmental and located predominantly in the right colon. Patients with AAHC typically present with abdominal pain and almost always bloody diarrhea. We present here the case of an adolescent patient who developed acute abdominal pain and bloody diarrhea after antibiotic treatment for acute urinary infection with amoxicillin-clavulanate. Right-sided colitis was verified by abdominal sonography. Stool culture tested negative for common gastrointestinal pathogens but yielded K oxytoca. Toxin production of the isolated strain was verified in a cell-culture assay. Cessation of the causative antibiotic treatment led to rapid improvement and cessation of bloody diarrhea within 3 days. We report here the first (to our knowledge) pediatric case of K oxytoca infection causing AAHC. Establishing the diagnosis of AAHC by culturing K oxytoca and demonstrating right-sided colitis with noninvasive imaging studies might prevent unnecessary invasive procedures in children with bloody diarrhea.

Consensus viewpoint on management of urinary infections

Twenty-four general practitioners completed a questionnaire on behalf of their partners in the practices before attending the symposium. The main points that emerged were that trimethoprim was the most popular antibiotic for treatment of acute urinary infection and that the most common duration of treatment was 5 to 7 days. A panel discussion, with audience participation, covered duration of treatment, antibiotic resistance, specimen collection, management of different patient groups and availability of information concerning resistance patterns. Nineteen of the original 24 general practitioners returned the post-meeting questionnaire, and stated that, as a result of what they had heard at the symposium, they were contemplating changing the way in which they managed urinary infections. Information concerning bacteriuria in pregnancy and changing patterns of bacterial resistance to antibiotics were of particular interest.

A Comparison of Cefaclor Versus Trimethoprim-Sulfamethoxazole Combination in the Treatment of Acute Urinary Infections

Acute lower urinary tract infections were treated in 57 women according to a randomized protocol, using either cefaclor, a cephalosporin whose chemical structure is similar to that of cephalexin, or trimethoprim-sulfamethoxazole combination. Urine cultures were made before treatment was started, midway through the 10-day course of therapy, 1 week after therapy and 4 to 6 weeks after therapy, if possible. Urine cultures in 100 per cent of the patients became sterile during therapy and remained so 1 week after therapy. Of those patients undergoing followup cultures 4 to 6 weeks after therapy 98 per cent had sterile urine. Twenty-nine patients were randomized to cefaclor therapy and 28 received a trimethoprim-sulfamethoxazole combination. There was no difference between the 2 drugs studied in terms of efficacy. No side effects were noted with cefaclor and 2 minor side effects were noted with the trimethoprim-sulfamethoxazole combination. Cefaclor in a twice daily dosage schedule appears to be a safe and useful drug in the treatment of urinary tract infections caused by the common gram-negative organisms and it appears to be as efficacious as the trimethoprim-sulfamethoxazole combination.

Single dose treatment of acute urinary infections in women.

Single dose treatment of acute urinary infections in women.

COMPARATIVE EFFICACY OF SULPHONAMIDE AND CO-TRIMOXAZOLE IN URINARY-TRACT INFECTIONS IN CEYLON

Of 82 patients with an acute urinarytract infection (U.T.I.) treated with sulphadimidine, 63 % had a positive urine culture 48-72 hours after the start of therapy. This was due to the high prevalence of sulphonamide-resistant organisms. Of 60 patients treated with the combination of trimethoprim and sulphamethoxazole (co-trimoxazole), in only 2 was the 48-72 hour urine culture positive. In Ceylon, where the prevalence of sulphonamide-resistant urinary pathogens is high, sulphonamides can no longer be considered the drugs of choice in the treatment of acute urinary infections.

ANTIBIOTIC RESISTANCE OF COLIFORM BACILLI IN URINARY INFECTION ACQUIRED BY WOMEN OUTSIDE HOSPITAL: A 12-year Survey

The drug resistance of coliform bacilli in urinary infections acquired by women outside hospital increased only slightly during a 12-year period. The proportion of drug resistance was similar in the predominant coliform flora of the fæces of healthy adults in the population. The results suggest that sulphonamides will probably retain their value for primary treatment of acute urinary infection outside hospital for some years to come.

Cycloserine in the Treatment of Acute Urinary Infections

Cycloserine in the Treatment of Acute Urinary Infections