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PubMed2001

Antibiotics for the prevention of urinary tract infection in children: A systematic review of randomized controlled trials.

OBJECTIVE: The objective was to evaluate the effectiveness of low-dose, long-term antibiotics for the prevention of symptomatic urinary tract infection (UTI) in children. DESIGN: This was a systematic review of randomized controlled trials with a random effects model meta-analysis. PARTICIPANTS: Five trials involving 463 children were performed. RESULTS: Three trials (n = 392) evaluated the effectiveness of long treatment courses of antibiotics (2 to 6 months) for children with acute UTI to prevent subsequent, off-treatment infection. Only 2 trials (n = 71) evaluated the effectiveness of long-term, low-dose antibiotics to prevent on-treatment UTI. Very few of the children enrolled in the trials were boys, had abnormal renal tracts, or were infants. The trial quality was poor, with a lack of blinding, and unstated UTI definitions were almost universal. Long-term antibiotic administration reduced the risk of UTI with treatment (relative risk 0.31, 95% confidence limits 0.10 to 1.00), but there was significant heterogeneity (Q = 13.45, P <.01), and there was no sustained benefit once antibiotics had ceased (relative risk 0.79, 0.61 to 1.02). CONCLUSIONS: Methodologic and applicability problems with published trials mean that there is considerable uncertainty about whether long-term, low-dose antibiotic administration prevents UTI in children. Well-designed, randomized, placebo-controlled trials are still required to evaluate this commonly used intervention.

Anti-Bacterial Agents↗
PubMed1995

Inhibitory effect of a conjugate between human urokinase and urinary trypsin inhibitor on tumor cell invasion in vitro.

Proteolytic enzymes such as urokinase-type plasminogen activator (uPA), plasmin, and collagenase mediate proteolysis by a variety of tumor cells. uPA secreted by tumor cells can be bound to a cell surface receptor via a growth factor-like domain within the amino-terminal fragment (ATF) of the uPA molecule with high affinity. Urinary trypsin inhibitor (UTI) efficiently inhibits the soluble and the tumor cell-surface receptor-bound plasmin and subsequently reduces tumor cell invasion and the formation of metastasis. The anti-invasive effect is dependent on the anti-plasmin activity of the UTI molecule, domain II in particular. We synthesized a conjugate between ATF of human uPA and a native UTI molecule or domain II of UTI (HI-8). The effect of the conjugates (ATF.UTI or ATF.HI-8) on tumor cell invasion in vitro was investigated. ATF.UTI and ATF.HI-8 bound to U937 cells in a rapid, saturable, dose-dependent, and reversible manner. A large part of receptor-bound ATF-UTI and ATF.HI-8 remains on the cell surface for at least 5 h at 37 degrees C. Inhibition of tumor cell-surface receptor-bound plasmin by ATF.UTI and ATF.HI-8 was markedly enhanced when compared with tumor cells treated either with ATF, UTI, or HI-8. Results of a cell invasion assay showed that ATF.UTI and ATF.HI-8 is very effective at targeting HI-8 specifically to uPA receptor-expressing tumor cells, whereas tumor cells devoid of uPA receptor may be less affected by the conjugates. Our results indicate that cell surface uPA and plasmin activity is essential to the invasive process and that the conjugates exhibit plasmin inhibition to the close environment of the cell surface and subsequently inhibit the tumor cell invasion through Matrigel in an in vitro invasion assay.

Amino Acid Sequence↗
PubMed2004

Management of urinary tract infections in primary care: a repeated 1-week diagnosis-prescribing study in five counties in Sweden in 2000 and 2002.

A diagnosis-antibiotic prescribing study was performed in 5 counties in Sweden during 1 week in November in the y 2000 and 2002, respectively. As part of the study, the characteristics and clinical management of patients who received diagnoses of urinary tract infections (UTIs) (n = 1564) in primary care, were analysed. 85% of the visits were by women, and 74% of all consultations were diagnosed as lower UTIs. One or more diagnostic tests were performed in 98% of the women with suspected lower or recurrent UTIs and 95% were prescribed an antibiotic. The most commonly prescribed antibiotics for lower UTIs were trimethoprim followed by pivmecillinam and a quinolone. The study indicated a change in antibiotic prescribing with improved adherence to the national recommendations. There was an increase of prescribed nitrofurantoin and a decrease of prescribed quinolones to women with lower UTIs between the studied y. Furthermore, 3-d treatment with trimethoprim increased although the prescribed duration was mostly 7 d. In contrast to the guidelines, few urine cultures were performed. The study highlights the necessity of updating the guidelines for the management of lower UTIs in general practice.

Adolescent↗
PubMed1998

Acute epididymitis and urinary tract anomalies in children.

OBJECTIVES: To evaluate the incidence of urinary tract infection (UTI) and genitourinary malformations in children presenting with acute epididymitis. PATIENTS AND METHODS: Twenty-five children between 2 months and 14 years of age presenting with acute epididymitis underwent urine culture, abdominal ultrasound, voiding cystourethrography and, in selected cases, intravenous pyelography. Eleven patients were infants and 14 were older than 1 year. UTIs and genitourinary malformations were recorded. Fisher's exact test was used to compare the incidence in two age groups. A p value of less than 0.05 was considered significant. RESULTS: Seven UTIs and eight genitourinary malformations were diagnosed in infants, while in older children three UTIs and three malformations were discovered. Infants had a higher rate of associated UTI (p 0.049) and genitourinary malformations (p 0.017) than did older children. CONCLUSIONS: Our data show a close relationship between acute epididymitis in infants for both UTIs and genitourinary malformations. Every infant presenting with epididymitis would undergo a complete evaluation including abdominal ultrasound and voiding cystourethrography. In older children the need for imaging should be dictated by clinical history and physical findings.

Acute Disease↗
PubMed1992

The prevention and management of urinary tract infections among people with spinal cord injuries. National Institute on Disability and Rehabilitation Research Consensus Statement. January 27-29, 1992.

The Urinary Tract Infection Consensus Conference brought together researchers, clinicians, and consumers to arrive at consensus on the best practices for preventing and treating urinary tract infections in people with spinal cord injuries; the risk factors and diagnostic studies that should be done; indications for antibiotic use; appropriate follow-up management; and needed future research. Urinary tract infection (UTI) was defined as bacteriuria (102 bacteria/ml of urine) with tissue invasion and resultant tissue response with signs and/or symptoms. Asymptomatic bacteriuria represents colonization of the urinary tract without symptoms or signs. Risk factors include: over-distention of bladder, vesicoureteral reflux, high pressure voiding, large post-void residuals, presence of stones in urinary tract, and outlet obstruction. Possible physiologic/structural, behavioral, and demographic risk factors were identified also. Indwelling catheterization, including suprapubic, and urinary diversion are the drainage methods most likely to lead to persistent bacteriuria. Infection risk is reduced with intermittent catheterization, but more severely disabled people who require catheterization by others are at greater risk for UTIs. Clean self-intermittent catheterization does not pose a greater risk of infection than sterile self-intermittent catheterization and is much more economic. However, care must be given to proper cleansing of reusable catheters. Quantitative urine-culture criteria for the diagnosis of bacteriuria include: catheter specimens from individuals on intermittent catheterization greater than or equal to 10(2) cfu/ml; clean-void specimens from catheter-free males using condom collection devices greater than or equal to 10(4) cfu/ml; and specimens from indwelling catheters of any detectable concentration. Dip stick screening tests may offer promise as an early warning system of UTI since they can be self-administered. Symptomatic UTI should be treated with antibiotics for 7 to 14 days. Longer courses have not been beneficial. In patients with symptomatic UTIs, it is not necessary to wait for the results of cultures before starting treatment. Asymptomatic bacteriuria need not be treated with antibiotics. There is little evidence presently to support the use of antibiotics to prevent infections. Following a recent episode of febrile UTI, possible contributing prior events should be reviewed. The upper tracts should be evaluated (imaging studies) to identify possible abnormalities. A common concern among people with spinal cord injuries is that physicians will alter bladder management programs without regard to lifestyle needs. Social/vocational flexibility may be more important to them than a state-of-the-art bladder management program. Future research should focus on obtaining more representative samples and investigate psycho-social-vocational implications as well as additional clinical-medical factors.

Anti-Bacterial Agents↗
PubMed1993

Progression from asymptomatic to symptomatic urinary tract infection in patients with SCI: a preliminary study.

The purpose of this prospective pilot study was to (1) evaluate the role of pyuria in predicting the progression from asymptomatic to symptomatic urinary tract infection (UTI) in spinal cord-injured patients who undergo sterile intermittent bladder catheterization and (2) evaluate the impact of treating asymptomatic UTI on this progression. Twenty hospitalized patients were randomized to either the treatment group (10 subjects) or the control group (10 subjects). Weekly urine samples were obtained for quantitation of bacterial growth and pyuria. Neither the level nor the trend of pyuria helped predict the imminent progression to symptomatic UTI. Thirty percent of patients in the treatment group developed symptomatic UTI vs 70 percent of patients in the control group; it took a significantly longer time for patients in the treatment vs control group to develop symptomatic UTI (median number of days: 72 vs 7, respectively; p < 0.003). Further analysis of the long-term impact of antibiotic treatment of asymptomatic UTI is warranted.

Adult↗
PubMed1998

Acupuncture in the prophylaxis of recurrent lower urinary tract infection in adult women.

OBJECTIVE: To evaluate the effect of acupuncture in the prevention of recurrent lower urinary tract infection (UTI) in adult women. DESIGN: A controlled clinical trial with three arms: an acupuncture group, a sham-acupuncture group, and an untreated control group. Patients were followed for 6 months. SETTING: An acupuncture clinic in Bergen, Norway. SUBJECTS: Sixty-seven adult women with a history of recurrent lower UTI. MAIN OUTCOME MEASURES: Acute lower UTIs during the 6-month observation period. RESULTS: Eighty-five percent were free of lower UTI during the 6-month observation period in the acupuncture group, compared with 58% in the sham group (p < 0.05), and 36% in the control group (p < 0.01). There were half as many episodes of lower UTI per person-half-year in the acupuncture group as in the sham group, and a third as many as in the control group (p < 0.05). CONCLUSION: Acupuncture seems a worthwhile alternative in the prevention of recurring lower UTI in women.

Acupuncture Therapy↗
PubMed2004

Effect of education and performance feedback on rates of catheter-associated urinary tract infection in intensive care units in Argentina.

OBJECTIVE: To evaluate the effect of education and performance feedback regarding compliance with catheter care and handwashing on rates of catheter-associated urinary tract infection (UTI) in intensive care units (ICUs). SETTING: Two level III adult ICUs in a private healthcare facility in Argentina. PATIENTS: All adult patients admitted to the study units who had a urinary catheter in place for at least 24 hours. METHODS: A prospective, open trial in which rates of catheter-associated UTI determined during a baseline period of active surveillance without education and performance feedback were compared with rates of catheter-associated UTI after implementing education and performance feedback. RESULTS: There were 1,779 catheter-days during the baseline period and 5,568 catheter-days during the intervention period. Compliance regarding prevention of compression of the tubing by a leg improved (from 83% to 96%; relative risk [RR], 1.15; 95% confidence interval [CI95], 1.03 to 1.28; P = .01) and so did compliance with handwashing (from 23.1% to 65.2%; RR, 2.82; CI95, 2.49 to 3.20; P < .0001). Catheter-associated UTI rates decreased significantly from 21.3 to 12.39 per 1,000 catheter-days (RR, 0.58; CI%, 0.39 to 0.86; P = .006). CONCLUSION: Implementing education and performance feedback regarding catheter care measures and handwashing compliance was associated with a significant reduction in catheter-associated UTI rates. Similar programs may help reduce catheter-associated UTI rates in other Latin American hospitals.

Aged↗
PubMed2003

Reclassification of urinary tract infections in critically ill trauma patients: a time-dependent analysis.

BACKGROUND: Successful treatment of urinary tract infections (UTIs) in the trauma ICU requires early recognition and timely, appropriate antibiotic therapy. We evaluated the incidence and microbiology of UTIs stratified by days post-admission and risk factors. METHODS: Prospective data were collected on 1,172 trauma patients admitted to the ICU over a two-year period. Infections were classified as Community Acquired (CA, < or = 3 days), Early Nosocomial (EN, 4-6 days), Mid-Nosocomial (MN, 7-10 days) and Late Nosocomial (LN > 10 days). Criteria of the U.S. Centers for Disease Control and Prevention (CDC) were used for diagnosis. RESULTS: Two hundred twenty patients (19%) were diagnosed with a total of 235 UTIs. Thirtysix patients were diagnosed with multiple UTIs. Escherichia coli, Enterococcus sp. and Candida sp. were the most common pathogens isolated. One thousand one hundred fifty-one patients had a Foley catheter placed (mean duration, 1 +/- 11 days) with a CDC device-related infection rate (no. of catheter-associated UTIs/1000 catheter days) of 18. Patients admitted with a CA infection were significantly older (p < 0.001) and had a higher mortality rate (39% vs. 15%, p = 0.001). Unanticipated pathogens in this group included Enterococcus, Candida, and Pseudomonas. Women were more likely to be admitted with a CA infection (5% vs. 1%, p < 0.001) or acquire an NI infection (23% vs. 15%, p < 0.001). Obesity was highly predictive of increased Foley catheter days, and thus UTI, by multivariate analysis (p < 0.001). CONCLUSIONS: Escherichia coli was the most common pathogen in all nosocomial infection categories. Increased age, gender, and obesity, in addition to catheter-days, were significant risk factors for UTI in trauma patients. Specific risk factors may predispose patients to pathogens that are not ordinarily covered by usually-chosen antibiotic therapy.

Adult↗
PubMed2005

Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial.

BACKGROUND: cranberry juice is often given to older people in hospital to prevent urinary tract infection (UTI), although there is little evidence to support its use. OBJECTIVE: to assess whether cranberry juice ingestion is effective in reducing UTIs in older people in hospital. DESIGN: randomised, placebo-controlled, double-blind trial. SETTING: Medicine for the Elderly assessment and rehabilitation hospital wards. SUBJECTS: 376 older patients in hospital. METHODS: participants were randomised to daily ingestion of 300 ml of cranberry juice or matching placebo beverage. The primary outcome was time to onset of first UTI. Secondary outcomes were adherence to beverage drinking, courses of antibiotics prescribed, and organisms responsible for UTIs. RESULTS: a total of 21/376 (5.6%) participants developed a symptomatic UTI: 14/189 in the placebo group and 7/187 in the cranberry juice group. These between-group differences were not significant, relative risk (RR) 0.51 [95% CI 0.21-1.22, P = 0.122). Although there were significantly fewer infections with Escherichia coli in the cranberry group (13 versus 4) RR 0.31 [95% CI 0.10-0.94, P = 0.027], this should be interpreted with caution as it was a secondary outcome. CONCLUSION: despite having the largest sample size of any clinical trial yet to have examined the effect of cranberry juice ingestion, the actual infection rate observed was lower than anticipated, making the study underpowered. This study has confirmed the acceptability of cranberry juice to older people. Larger trials are now required to determine whether it is effective in reducing UTIs in older hospital patients.

Aged↗
PubMedDate not supplied

Comparative studies of fluoroquinolones in the treatment of urinary tract infections.

The results of comparative trials of fluoroquinolones for the treatment of uncomplicated and complicated urinary tract infections (UTI) were reviewed. Several randomized, comparative trials showed that in uncomplicated UTI norfloxacin, ciprofloxacin, and ofloxacin were at least as effective as trimethoprim-sulfamethoxazole (TMP-SMZ) and amoxicillin and usually more effective than nalidixic acid, pipemidic acid, and nitrofurantoin. Comparative trials of single-dose regimens have, however, been limited. A few randomized, comparative trials have shown that in complicated UTI norfloxacin, ciprofloxacin, and ofloxacin were at least as effective as amoxicillin and TMP-SMZ and usually more effective than pipemidic acid. Moreover, preliminary results indicate that fluoroquinolones might be effective for the oral treatment of complicated UTI that are difficult to treat, especially those due to Pseudomonas aeruginosa. Comparative trials are needed to establish the value of fluoroquinolones for chronic bacterial prostatitis. There are no conclusive data on fluoroquinolone treatment of UTI in patients with renal failure. Emergence of resistant pathogens during therapy with fluoroquinolones has been infrequent but might be more frequent in complicated UTI caused by P. aeruginosa.

Clinical Trials as Topic↗
PubMed1996

Recurrence of urinary tract infection in a primary care setting: analysis of a 1-year follow-up of 179 women.

In a prospective study, 179 adult women (age range, 17-82 years) were followed up for 12 months after an index episode of community-acquired cystitis caused by Escherichia coli. Episodes of symptomatic urinary tract infection (UTI) were recorded, and urinary isolates were compared with the index episode isolate; 147 UTI episodes were detected during the follow-up. Of these episodes, 131 were classified as recurrences occurring at least 1 month after the index episode; 44% of the patients had recurrences. A history of UTI increased the risk of recurrence; only 11.8% of the 17 patients without previous episodes of UTI had at least one recurrence, while 47.5% of those with previous episodes had at least one recurrence (OR, 6.8; univariate logistic regression). E. coli caused 78% of the recurrent episodes. Phenotypic and genotypic analysis of E. coli strains showed that one-third of the recurrences were caused by the index episode strain, which could persist and cause recurrences throughout the 1-year follow-up period. The prevalence of adhesins or other identified virulence factors for UTI among the recurrence strains was identical to that among the index episode strains. The presence of these factors did not affect the risk of recurrence but did increase the likelihood that the index episode strain would persist and cause recurrent episodes of UTI.

Adolescent↗
PubMedDate not supplied

A controlled study of trimethoprim-sulfamethoxazole prophylaxis of urinary tract infection in renal transplant recipients.

Urinary tract infection (UTI) during the four months after renal transplantation occurs in 30%-40% of recipients at the Massachusetts General Hospital and is often associated with gram-negative bacteremia, significant graft dysfunction, and relapse. Of these "early" UTIs, 90% affect the graft itself. In a randomized trial of prophylaxis of UTI with trimethoprim-sulfamethoxazole (TMP-SMZ), 52 consecutive allograft recipients received either no prophylaxis or one TMP-SMZ tablet (160 mg of TMP plus 800 mg of SMZ) daily for four months, beginning on removal of the Foley catheter (usually during the first four days after transplantation). Three of the first five patients given TMP-SMZ developed oral candidiasis; they and all subsequent recipients of TMP-SMZ were given oral mycostatin throughout prophylaxis. Two of 26 patients (8%) taking TMP-SMZ developed UTIs; 10 of 26 patients (38%) not taking the drug developed UTIs with evidence of graft infection (P less than 0.05). The two groups were comparable in age, sex, history of UTI before transplantation, type of donor, type of ureteral anastomosis, and antibiotic use for other types of infection. Only one complication, a skin eruption, was observed among patients taking TMP-SMZ and mycostatin. It is concluded that TMP-SMZ is well tolerated and effective prophylaxis in this setting.

Adult↗
PubMedDate not supplied

Staphylococcus saprophyticus as a common cause of urinary tract infections.

Until the last decade, coagulase-negative staphylococci occurring in urine specimens were usually regarded as a contaminant. In the early 1970s, i.e., more than ten years after the original demonstration of Staphylococcus saprophyticus in urine specimens, this species became recognized as a frequent cause of urinary tract infections (UTI). In young women, S. saprophyticus is, after Escherichia coli, the second-most-frequent causative agent of acute UTI. Patients with UTI caused by S. saprophyticus usually present with symptomatic cystitis. Signs and symptoms of renal involvement are also often registered. The urine sediment of a patient with UTI caused by S. saprophyticus has a characteristic appearance microscopically. Chemical screening methods for bacteriuria do not always succeed in diagnosing UTI caused by S. saprophyticus. Even when such an infection occurs above the neck of the bladder, low numbers of colony-forming units (less than 10(5) cfu/ml) of S. saprophyticus are comparatively often found in the bladder and voided urine. S. saprophyticus is usually susceptible to antibiotics commonly prescribed for patients with UTI, with the exception of nalidixic acid. The bacterium has a capacity for selective adherence to human urothelium. It causes direct hemagglutination. The adhesin for S. saprophyticus is a lactosamine structure. This staphylococcal species produces an extracellular enzyme complex that can inhibit growth of both gram-positive and gram-negative bacteria.

Adhesiveness↗
PubMed2003

What is the predictive value of urinary symptoms for diagnosing urinary tract infection in women?

OBJECTIVES: Our aim was to determine the probability of correctly diagnosing urinary tract infections (UTIs) from urinary symptoms and signs, studying their sensitivity, specificity and likelihood ratio (LR) when clinical history, signs and reactive strip test results are taken into account. METHODS: An epidemiological analysis with a diagnostic and clinical orientation was carried out in a primary health care setting. The subjects comprised 343 women > or =14 years of age who consulted their family physician for incident urinary tract symptoms. A guided medical examination was carried out using a check-list formulary, reactive strip test, urine culture and the clinical course of all patients. RESULTS: The pre-test probability of having UTI among patients with incident urinary symptoms is 0.484 [95% confidence interval (CI) 0.431-0.536]. Positive LRs for UTI are: painful voiding 1.31 (95% CI 1.12-1.54), urgency 1.29 (95% CI 1.12-1.50), urinary frequency 1.16 (95% CI 1.06-1.28) and tenesmus 1.16 (95% CI 1.02-1.32). The probability of UTI is reduced by the presence of genital discomfort, dyspareunia, vaginal discharge, positive lumbar fist percussion and perineal discomfort. Nitrites on the urine reactive strip test increase the probability of UTI by >5 times, moderate pyuria increases it by >1.5 times, and the presence of both findings does so by >7 times. CONCLUSIONS: In women with urinary symptoms, a thorough clinical examination, together with performance of a reactive strip test during the office visit, improves the chances of detecting UTI.

Adolescent↗
PubMed1995

Chromosomal restriction fragment length polymorphism analysis of Escherichia coli strains causing recurrent urinary tract infections in young women.

To determine whether recurrent, symptomatic urinary tract infections (UTIs) in a given individual are due to the same or different strains, 71 Escherichia coli strains that caused recurrent UTIs were prospectively collected from 23 infection-prone young women and studied by chromosomal restriction fragment length polymorphism (RFLP) analysis using pulsed-field gel electrophoresis. Thirty-five strains from women with first-episode UTIs were also studied. Overall, 30 (68%) of 44 recurrent UTIs were caused by a strain previously identified in that person. In contrast, 32 of 35 strains from first-episode UTIs had unique RFLP profiles. Analysis of a subset of subjects established that the majority of recurrent UTIs were due to reinfection, not persistence of the pathogen within the urinary tract, and suggested that the colonic flora was the reservoir for these reinfecting strains.

Adolescent↗
PubMed1995

Western blot analysis of anti-Escherichia coli serum immunoglobulins in women susceptible to recurrent urinary tract infections.

The basis for increased susceptibility of some women to recurrent urinary tract infections (UTIs) is not clear; increased susceptibility may be due to host factors that promote increased colonization of the vaginal and bladder mucosa with uropathogens or to decreased immune responses to uropathogens. Anti-Escherichia coli antibody specificities in sera from UTI patients and controls were comprehensively assessed to determine whether UTI-susceptible and -nonsusceptible women differed in their capacities to make antibodies to individual E. coli antigens. Sera were analyzed by one-dimensional Western blots using antigens prepared from uropathogenic E. coli. The results showed that sera from subjects without a history of recurrent UTIs contained IgG antibodies to specific E. coli antigens more often than did sera from UTI-susceptible patients. These data suggest that hyporesponsiveness to specific E. coli antigens may be linked to increased UTI susceptibility in some women.

Adult↗
PubMed1990

Cefodizime in clinical use: a review of the clinical trial reports.

The clinical efficacy of cefodizime has been tested in several open and comparative studies, above all in lower respiratory tract infections (LRTI) and uncomplicated urinary tract infections (UTI), performed in 151 centres in Europe, Latin America, South-Eastern Asia and South Africa. Of 3791 patients, 2260 could be evaluated for efficacy and safety. Comparative studies in LRTI were carried out vs cefotaxime and cefuroxime (301 vs 299 patients); both clinical and bacteriological results were superimposable (range of satisfactory clinical outcomes from 86% to 95%; bacteriological eradication 95% to 100%). In open studies (533 evaluable patients) the percentage of clinical successes ranged from 79.1% to 91.8% and the bacteriological eradication from about 87% to 90%, according to the type of infections. Comparative studies (cefodizime vs cefuroxime or ceftizoxime) in UTI again demonstrated the equivalence of treatment. In open studies (374 evaluable patients) the percentage of satisfactory clinical outcomes ranged from 84.6% in complicated upper UTI to 95.9% in lower uncomplicated UTI, with overall bacteriological eradication of 92.7%. Side effects could be evaluated in 5801 patients (Western and Japanese clinical studies); 3.79% of patients showed side effects (1.99% gastrointestinal disturbances, 0.9% rash or urticaria, 0.9% other effects); 1.13% of patients required discontinuation of treatment. No relevant changes in laboratory parameters were observed. Cefodizime has been shown to be an effective and safe agent in the treatment of LRTI and UTI caused by susceptible pathogens. A dosage regimen of 1 g every 12 h seems to be the most suitable schedule for the treatment of LRTI while 1 g every 12 h or 2 g every 24 h can equally well be adopted for treatment of UTI.

Bacterial Infections↗