Urinary tract infections uncomplicated

Same as ciprofloxacin, urinary tract infections, uncomplicated gonorrhea, prostatitis Same as ciprofloxacin Same as ciprofloxacin... 

From a clinical point of view, the sulphonamides are extremely useful for the treatment of uncomplicated urinary tract infection caused by E. coli in domiciliary practice. They have also been employed in treating meningococcal meningitis (a current... 

Describe the organism responsible for the majority of uncomplicated urinary tract infections. 

O Urinary tract infections are thought of as complicated and uncomplicated. Generally this refers to presence or absence, respectively, of functional or structural abnormalities within the urinary tract. 

Christensen B. Which antibiotics are appropriate for treating bacteriuria in pregnancy. J Antimicrob Chemother 2000 46(Suppl Sl) 29—34. Finn SD. Acute uncomplicated urinary tract infections. Med Clin North Am 1997 81 719-729. 

Perfetto EM, Gondek EK. Escherichia coli resistance in uncomplicated urinary tract infection a model for determining when to change first-line empirical antibiotic choice. Manag Care Interface 2002 6 35M2. 

Uncomplicated urinary tract infection (UTI) Generally used to describe a UTI in a patient without structural or functional abnormalities of the urinary tract. 

Lower respiratory and urinary tract infections 400 mg qd. Uncomplicated gonorrhea 400 mg once photosensitivity. 

Cefalexin is a first-generation cephalosporin and therefore an alternative preparation would be Zinnat tablets, which contains cefuroxime, a second-generation cephalosporin. A penicillin such as Augmentin, which contains co-amoxiclav, can be an appropriate alternative since it provides a very similar spectrum of activity. Klaricid contains clarithromycin, which is a macrolide. Utinor contains norfloxacin, which is a quinolone that is effective in uncomplicated urinary-tract infections. Rocephin contains ceftriaxone, which is a third-generation cephalosporin that is available for parenteral administration only. 

Sulfouamides have a broad spectrum of antimicrobial activity, including Staphylococcus aureus, nonenterococcal types of Streptococcus, Listeria monocytogenes, Nocardia, Neisseria, Haemophilius influenzae, enteric Gram-negative types of E. coli, Proteus mirabilis, and a few forms of anaerobic bacteria. Above all, sulfonamides are used for treating uncomplicated infections of the urinary tract, infections caused by Nocardia asteroids, streptococcal pharyngitis, menigococcal diseases, toxoplasmosis, and others. 

Urinary tract infections - For uncomplicated lower urinary tract infection (eg, cystitis), the usual dosage is 1 or 2 g/day in single or 2 divided doses. For all other urinary tract infections, the usual dosage is 2 g/day in 2 divided doses. 

Mild to moderate uncomplicated or complicated urinary tract infections, including pyelonephritis, caused by Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis.- 0.5 to 1 g IV/IM q 12 h 7 to 10... 

Pediatric patients (2 months to 16 years of age) - Treatment of uncomplicated and complicated urinary tract infections (including pyelonephritis), uncomplicated skin and skin structure infections, pneumonia, and as empiric therapy for febrile neutropenic patients. 

Uncomplicated urinary tract infection 200 mg 100 mg every 12 h 7 days... 

Urinary tract infections (complicated and uncomplicated) - Enterococcus faecalis, S. awrews (penicillinase-producing), E. coli, Klebsiella sp.,... 

XR tabiets No dosage adjustment is required for patients with uncomplicated urinary tract infections receiving 500 mg ciprofloxacin XR. In patients with complicated urinary tract infections and acute uncomplicated pyelonephritis who have a Ccr of less than 30 mL/min, reduce the dose of XR tablets from... 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

Trimethoprim is a competitive inhibitor of the enzyme dihydrofolate reductase and can thus prevent the formation of tetrahydrofolate thereby blocking the synthesis of purines. The affinity of trimethoprim for the enzyme in microorganisms is 10,000 times higher than for the human enzyme which explains the selective toxicity. Used alone its main indication is acute uncomplicated urinary tract infections. It is then as effective as co-trimoxazole but has the advantage of fewer adverse reactions. 

For infections frequently encountered outside hospitals, e.g. uncomplicated urinary tract infection in young women, surveillance of resistance data of the most likely pathogens Escherichia coli) allows physicians to prescribe empiric therapy without performing cultures in the individual patient. However, in severely ill hospitalised patients, it is necessary to take samples for culture before starting empiric therapy. Microscopy of the Gram stained smear can help fine-tune empiric therapy at an early stage. Whether the infection is community-acquired or hospital-acquired, and whether the patient has been exposed to previous antimicrobial therapy should also be taken into account when choosing empiric therapy. 

The minimally required duration of treatment is only known for a limited number of infections. Clinical trials have shown the effectiveness of a single dose in the treatment of gonorrhoea or uncomplicated urinary tract infection in women and in surgical prophylaxis. The more precise duration of treatment has been studied for endocarditis, meningitis and staphylococcal bacteraemia. More often, guidelines for duration of treatment have been based on clinical experience with similar infections and on the parameters of response mentioned above. Failure of treatment should be recognised early. It can be due to a variety of reasons (Table 2). 

Acute uncomplicated urinary tract infections caused by E. coli and other pathogens generally respond promptly to one of the short-acting sulfonamides. Recurrent urinary tract infections (UTIs), when related to some structural abnormality in the tract, are frequently caused by sulfonamide-resistant bacteria. 

In the treatment of uncomplicated urinary tract infection caused by gram-negative bacteria, the therapy of choice would be... 

Fosfomycin is approved for use as a single 3-g dose for treatment of uncomplicated lower urinary tract infections in women. The drug appears to be safe for use in pregnancy. 

A 59-year-old woman presents to an urgent care clinic with a 4-day history of frequent and painful urination. She has had fevers, chills, and flank pain for the last 2 days. Her physician advised her to immediately come to the clinic for evaluation. In the clinic she is febrile (38.5°C [101.3°F]) but otherwise stable and states she is not experiencing any nausea or vomiting. Her urine dipstick test is positive for leukocyte esterase. Urinalysis and urine culture are also ordered. Her past medical history is significant for three urinary tract infections in the past year. Each of these episodes was uncomplicated, treated with trimethoprim-sulfamethoxazole, and promptly resolved. She also has osteoporosis for which she takes a daily calcium supplement. The decision is made to treat her with oral antibiotics for a complicated urinary tract infection with close follow-up. Given her history what would be a reasonable empiric antibiotic choice Depending on the antibiotic choice are there potential drug interactions she should be counseled on ... 

Nitrofurantoin is bacteriostatic and bactericidal for many gram-positive and gram-negative bacteria but P aeruginosa and many strains of proteus are resistant. There is no cross-resistance between nitrofurantoin and other antimicrobial agents and resistance emerges slowly. As Escherichia coli resistant to trimethoprim-sulfamethoxazole and fluoroquinolones has become more common, nitrofurantoin has become an important alternative oral agent for treatment of uncomplicated urinary tract infection. 

Aminoglycosides are NOT indicated for the treatment of uncomplicated urinary tract infections these Infections respond to less toxic antimicrobial agents, such as trimethoprim-sulfamethoxazole. 

Cefdinir Omnicef PO Community-acquired pneumonia, otitis media, sinusitis, skin and soft tissue infections, uncomplicated urinary tract infections... 

Sulfemethoxazole in combination with trimethoprim is an effective and inexpensive treatment for acute uncomplicated urinary tract infection. This combination is also useful for treatment of Pneumocystis carinii pneumonitis in immunologically impaired patients. 

Nalidixic acid NegGram Uncomplicated urinary tract infections... 

Fosfomycin is a broad-spectrum antibiotic used to treat uncomplicated lower urinary tract infections. It penetrates interstitial space fluids of soft tissues well and reaches concentrations sufficient to substantially inhibit the growth of relevant bacteria at the target site (1). 

In a multicenter trial in 749 ambulatory women aged at least 12 years with an acute uncomplicated urinary tract infection, a single dose of fosfomycin tromethamine 3 g had an equivalent bacteriological and clinical cure rate as a 7-day course of nitrofurantoin (4). Adverse events were reported by 5.3% of fosfomycin-treated patients (versus 5.6%). The most common adverse effects were diarrhea (2.4%), vaginitis (1.8%), and nausea (0.8%), and 1.9% of fosfomycin-treated patients were withdrawn owing to adverse events (versus 4.3%). 

Stein GE. Comparison of single-dose fosfomycin and a 7-day conrse of nitrofurantoin in female patients with uncomplicated urinary tract infection. Clin Ther 1999 21(ll) 1864-72. 

In phase II trials oral gemifloxacin 320 mg/day produced bacteriological responses in 94% of patients with acute exacerbations of chronic bronchitis (6-8) and in 95% of patients with uncomplicated urinary tract infections. Adverse events included nausea, abdominal pain, headache, and a mild rash in both patients and healthy volunteers. 

Spencer RC, Moseley DJ, Greensmith MJ. Nitrofurantoin modified release versus trimethoprim or co-trimoxazole in the treatment of uncomplicated urinary tract infection in general practice. J Antimicrob Chemother 1994 33(Suppl A) 121-9. 

There have been few comparisons of the efficacy of trimethoprim and co-trimoxazole. In uncomplicated urinary tract, bronchopulmonary, and ear infections, no advantage of co-trimoxazole over trimethoprim has been documented (7,8). However, in complicated urinary tract infections most studies have shown better results with co-trimoxazole than with trimethoprim alone (9). Despite the widespread use of co-trimoxazole for about 35 years, bacterial resistance has not emerged as a major problem (10,11). 

Urinary tract infections can be classified by anatomic site of involvement into lower and upper urinary tract infections. Lower UTls include cystitis, urethritis, prostatitis, and epididymitis, whereas upper urinary tract infections include pyelonephritis. UTls also may be further classified as complicated or uncomplicated. In females with a structurally normal urinary tract, both cystitis and pyelonephritis are considered uncomplicated UTls. UTls in men, elderly individuals, pregnant women, or patients with in-dwelling... 

Enoxadn, USP. l-Ethyl-6-fluoro-l.4-dihydro-4-oxo-7-(I-piperazinyI)-I,8-naphthyridine-3-carboxylic acid (Pene-irex) is a quinolone with broad-spectrum antibacterial activity that is used primarily for the treaimenl of urinary tract infections and. sexually transmitted diseases. Enoxacin has been approved for the treatment of uncomplicated gonococcal urethritis and has also been shown to be effective in chancroid caused by Haemophilus ducreyi. A single 400-mg dose is used for these indications. Enoxacin is also approved for the treatment of acute (uncomplicated) and chronic (complicated) urinary tract infections. 

---