Treatment of recurrent urinary tract infection with norfloxacin versus trimethoprim-sulfamethoxazole.

Norfloxacin, a broad-spectrum antimicrobial analog of nalidixic acid, was evaluated by comparing it to trimethoprim-sulfamethoxazole in 93 office patients with recurrent urinary tract infections. In this prospective randomized study, norfloxacin and trimethoprim-sulfamethoxazole were given on the same dosage schedule with the former drug given as a 400-mg tablet twice daily and the latter drug given as a double strength tablet twice daily. Overall, 50 patients received norfloxacin and 43 patients received trimethoprim-sulfamethoxazole with a cure rate of 96 percent and 79 percent, respectively.

A multicenter, double-blind, trimethoprim-sulfamethoxazole controlled study of enoxacin in the treatment of patients with complicated urinary tract infections.

In a double-blind, randomized, controlled trial, 249 patients with complicated urinary tract infections received either 400 mg. enoxacin or 160 mg. trimethoprim plus 800 mg.

Tissue penetration and clinical efficacy of enoxacin in urinary tract infections.

The fluoroquinolones in general, and particularly enoxacin, show great promise in the treatment of urinary tract infection. Orally administered enoxacin achieves high concentrations in the serum and urine as well as in prostate tissue, kidney and perirenal fat and muscle. These concentrations are generally in excess of the minimum inhibitory concentrations (MIC) for 95% of the common uropathogens, including Escherichia coli, Pseudomonas aeruginosa, Klebsiella spp.

Management of urinary tract infections.

Community-acquired urinary tract infections account for millions of physician visits per year. When urinary tract infections develop in hospitalized patients, they not only increase the duration of hospitalization (and thus its cost) but also have a serious and sometimes devastating impact on the incidence of morbidity and mortality. Treatment depends on the clinical setting, the causative organism, the site of infection, and the patients' host defenses.

Antibiotic genitourinary surgical prophylaxis.

Urologists continue to use antibiotics inappropriately. We should rethink the reasons why certain attitudes exist about powerful drugs for prophylaxis and adjust our prescribing habits for therapy as well. Using catheters and urethral instrumentation sparingly and only when necessary, while employing proper infection control techniques and judicious antibiotic prophylaxis can control the nosocomial infections resulting from genitourinary surgery.

Aztreonam.

Aztreonam is a new, totally synthetic beta-lactamase agent--the first monobactam. It is highly resistant to hydrolytic inactivation caused by plasmid-mediated (except PSE-2 enzyme found in some Pseudomonas species) or chromosomally mediated beta-lactamases (except for K1 produced by rare strains of Klebsiella oxytoca). Accordingly, aztreonam remains active against many pathogens that are resistant to other beta-lactam antibiotics.

Upper and lower urinary tract infections: amikacin's role in managing surgical complications.

Approximately one out of every 40 patients admitted to United States hospitals each year acquires a urinary tract infection while hospitalized. Urologic instrumentation is the precipitating cause in 75 to 80 percent of the cases. Such infections are responsible for a mortality rate among these patients that is three times the rate observed for all other hospitalized patients.

Appropriate surgical prophylaxis in transurethral genitourinary surgery and potential reduction in nosocomial infections.

Despite the high rate of urinary tract infections seen in hospitals, until recently many surgeons did not advise antibiotic prophylaxis for transurethral genitourinary surgery. This situation has changed with the realization that older trials with questionable results were poorly designed. Several recent well-controlled clinical studies show that appropriate antibiotic prophylaxis greatly reduces the high incidence of infections following transurethral genitourinary surgery.

Treatment of bacterial prostatitis. Comparison of cephalexin and minocycline.

The relative safety and efficacy of minocycline and cephalexin were examined in patients with acute or chronic prostatitis. The multicenter study was of single-blind, parallel-group design. Forty-two men received minocycline (200-mg initial dose followed by 100 mg twice daily) and 44, cephalexin (500 mg four times daily); each antibiotic was administered orally for four weeks.

Role of piperacillin in surgical prophylaxis of genitourinary infections.

One hundred sixty-five men and women undergoing open or transurethral urologic surgery participated in a study designed to compare the prophylactic efficacy and safety of piperacillin with those of cefotaxime when administered perioperatively. The piperacillin-treated group received 2 Gm one hour before surgery and 2 Gm three hours later, and the cefotaxime-treated group was administered 1 Gm on the same schedule. In 9 per cent of the piperacillin-treated patients and in 11 per cent of the cefotaxime-treated patients postoperative urinary tract infections developed, although no patient in either group had sepsis.

Perioperative mezlocillin vs cefotaxime to prevent infections after genitourinary surgery.

This is a report of a randomized, comparative, double-blind study of mezlocillin and cefotaxime given perioperatively to 100 patients undergoing genitourinary surgery. Of 94 evaluable patients, 2 (4.7%) in the mezlocillin group and 2 (3.

Aztreonam in the treatment of urinary tract infection.

The possible advantages of the monobactam antibiotic aztreonam in the treatment of hospital-acquired urinary tract infection were assessed in a study comparing aztreonam (0.5 to 1 g twice daily or three times daily) to cefamandole (1 g three times daily) in 159 patients. Initial pathogens were eradicated in 91.

Ceftriaxone for once-a-day therapy of urinary tract infections.

Ceftriaxone given once-a-day was compared with cefazolin given three times daily as therapy for complicated and uncomplicated urinary tract infections. One hundred ten patients were randomly assigned to receive either 1 g of ceftriaxone every 24 hours or 1 g of cefazolin every eight hours. Standard bacteriologic methods were used to identify the pathogens and their susceptibilities before treatment and at intervals during and after treatment.

Ceftriaxone in the prevention of postoperative infection in patients undergoing transurethral resection of the prostate.

One hundred twenty-nine patients undergoing transurethral resection of the prostate were treated preoperatively with either 1 g of ceftriaxone or placebo in a double-blind, randomized study. Sixty-three patients received placebo and 66 received ceftriaxone. Postoperative urinary tract infections developed in eight placebo-treated patients, for a 12.

Antibiotic prophylaxis in elective genitourinary tract surgery: a comparison of single-dose pre-operative cefotaxime and multiple-dose cefoxitin.

In a randomized, single-blind study, the efficacy of single-dose cefotaxime was compared with multiple dose cefoxitin in genitourinary surgery prophylaxis. Patients received either 1.0 g cefotaxime before surgery; or 2.

Ceftazidime, an open randomized comparison of 3 dosages for genitourinary infections.

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.