Urinary tract infections prevention

Chlorhexidine has found other medical appHcations, eg, in urology in preventing urinary tract infections (217), in obstetrics and gynecology (218), in controlling infection in bums and wounds (219), and in the prevention of oral disease (220). Hypersensitivity to chlorhexidine has been reported in Japan (221) but 0.05% concentration is considered to be safe. 

Cranberry juice has long been recommended for use in treating and preventing urinary tract infections (UTIs). Clinical studies have confirmed that cranberry juice is beneficial to individuals with frequent UTIs Cranberries inhibit bacteria from attaching to the walls of the urinary tract and prevent certain bacteria from forming dental plaque in the mouth. Cranberry juice is safe for use asa food and for urinary tract health. Cranberry juice and capsules have no contraindica-tions no known adverse reactions and no drug interactions The recommended dosage is9 to 15 capsules a day (400-500 mg/d) or 4 to 8 ounces of juice per day. (See Chap. 6 for more information.)... 

Howell, A. B. (2007). Bioactive compounds in cranberries and their role in prevention of urinary tract infections. Mol. Nutr. Food Res. 51, 7 i2-7 i7. 

Kontiokari, T., Sundqvist, K., Nuutinen, M., Pokka, T., Koskela, M., and Uhari, M. (2001). Randomized trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. Br. J. Nutr. 322,1571-1573. 

Another group of compounds, the tetracyclines, are made by fermentation procedures or by chemical modifications of the natural product. The hydrochloride salts are used most commonly for oral administration and are usually encapsulated because of their bitter taste. Controlled catalytic hydrogenolysis of chlortetracycline, a natural product, selectively removes the 7-chloro atom and produces tetracycline. Doxycycline and minocycline are other important antibacterials. Tetracycline can be prescribed for people allergic to penicillin. Doxycycline prevents traveler s diarrhea. Tetracyclines help many infections including Rocky Mountain spotted fever, Lyme disease, urinary tract infections, bronchitis, amoebic dysentery, and acne. 

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. 

Especially in younger children, uninhibited and unpredictable detrusor contractions can be caused by constipation alone, by lower urinary tract infections (UTIs), or by constipation-associated UTls (Yazbeck et ak, 1987 Reiner, 1995). Pediatric pelvic organ structural immaturity prevents complete bladder filling by colorectal obstipation and hyperdistention. By contrast, mature vaginal-uterine or prostatic structural... 

The dosage for urinary tract infection in adults is 100 mg orally taken four times daily. The drug should not be used to treat upper urinary tract infection. Oral nitrofurantoin can be given for months for the suppression of chronic urinary tract infection. It is desirable to keep urinary pH below 5.5, which greatly enhances drug activity. A single daily dose of nitrofurantoin, 100 mg, can prevent recurrent urinary tract infections in some women. 

A new E. coh vaccine for prevention of urinary tract infections developed. 

Cranberry has been used to prevent and treat urinary tract infections since the 19th century. Today, cranberry juice is widely used for the prevention, treatment, and symptomatic relief of urinary tract infections. Cranberry juice is also given to patients to help reduce urinary odors in incontinence. Another potential benefit of cranberry is a decrease in the rate of formation of kidney stones. 

Many species of phyllanthus have been used in Ayurvedic medicine for more than 2000 years. It is a traditional remedy for ailments such as jaundice, dysentery, diabetes, skin ulcers, and urinary tract infections. Phyllanthus s principal constituents — lignans, alkaloids, and bioflavonoids — have been found to act primarily on the liver, which confirms its traditional use in the treatment of jaundice. Phyllanthus amarus attracted the attention of Nobel prize winner Baruch Blumberg. He and others studied its uses in preventing hepatitis B and devised a vaccine. 

Cranberry enhances the excretion of hippuric acid, a bacteria-fighting chemical. Recent studies support the speculation that eating cranberries or drinking their juice can prevent or fight urinary tract infections. Hippuric acid prevents Escherichia coli (E. coli) from adhering to the urinary tract. Cranberries also contain arbutin, which fights yeast infections. The berries are also used as a urinary deodorant. ... 

Blueberries contain condensed tannins that help prevent urinary tract infections. Blueberries contain Anthocyanin (which is responsible for its deep blue color), which is a flavonoid, a plant antioxidant (see Chapter 8 and Chapter 31). Flavonoids such as anthocyanin found in blueberries have a different chemical structure compared to other common antioxidants such as vitamin C, which makes them three to four times more potent. Antioxidants neutralize the effects of free radicals, which are unstable molecules that can attack human cells and damage their DNA. 

May help prevent some urinary tract infections... 

Inflammation is a common component associated with sepsis, meningitis, as well as respiratory tract, urinary tract, viral, and bacterial infections (Table 1). Bik is elevated during bacterial or viral infection. The presence of urinary Bik correlates well with standard urinalysis tests for urinary tract infections [20]. Endotoxins released from infectious pathogens induce inflammation and immune cell activation. Macrophages release interleukins and cytokines (IL-1, IL-6, IL-12, IL-15, IL-18, TNF-a) on exposure to lipo-polysaccharide (LPS) and lipoteichoic acid (LTA) endotoxins. These cytokines act as a chemotactic factors causing immune cell migration to the site of the infection followed by activation and release of proteases. Cytokines also induce increased vascular permeability in the endothelial. Bik suppresses further cytokine release by protease and intern additional migration and activation of immune cells. Additionally, a stabilization of the immune cell membrane prevents further release of proteases [4]. 

Eriksen, B. (1999), A randomized, open, parallel-group study on the preventive effect of an estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections in postmenopausal women, Am. J. Obstet. Gynecol., 180,1072-1079. 

Cranberries have been used traditionally for the treatment and prevention of urinary tract infections. Their effectiveness was demonstrated by a randomized, double-blind placebo-controlled trial (Avom et ah, 1994). Escherichia coli are the principal bacterial species responsible for urinary tract infection. The consumption of cranberry juice reduced the adherence of E. coli to the uroepithelial bladder cells in healthy human volunteers (Di Martino et ah, 2006). A-type procyanidin dimers and trimers that were isolated from cranberries were found to inhibit the adherence of uropathogenic E. Coli, whereas (—)-epicatechin and a B-type dimer were not effective (Foo et ah, 2000). 

True prevention of primary infection rheumatic fever, recurrent urinary tract infection. 

Ofloxacin (t/ 4h) has modestly greater Grampositive activity, but less Gram-negative activity than ciprofloxacin. It is indicated for urinary and respiratory tract infections and gonorrhoea. Nalidixic acid (t5 6 h) is now used principally for the prevention of urinary tract infection. It may cause haemolysis in glucose-6-phosphate dehydrogenase deficient subjects. 

The administration of pivaloyl-conjugated beta-lactam antibiotics to healthy volunteers for 54 days reduced mean serum carnitine 10-fold and muscle carnitine, as measured per non-collagen protein, more than 2-fold (62). Long-term treatment of children for 12-37 months to prevent urinary tract infection resulted in serum carnitine concentrations of 0.9-3.6 pmol/l (reference range 23-60 pmol/l). In four cases, muscle carnitine was 0.6-1.4 j,mol/g non-collagen protein (reference range 7.1-19) (63). 

Salveson A, Bergan T. Contamination of chlorhexidine cream used to prevent ascending urinary tract infections. J Hyg (Lond) 1981 86(3) 295-301. 

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