Oxolinic acid in the treatment of urinary tract infections.

Oxolinic acid was successfully used in eradicating bacteriuria in 86% of a highly selected group of 42 patients with chronic and recurrent urinary infections. Thirty-eight (92%) of patients had underlying renal abnormalities, 19 (45%) had impaired renal function. Emergence of resistant organisms in 3 patients (7%), and a high incidence of side effects necessitating withdrawal of treatment in 12 patients (29%), limit the usefulness of this agent to special situations. In patients with moderate and severe renal impairment, oxolinic acid achieves adequate urinary concentration, does not accumulate in the serum and is not nephrotoxic. The drug is safe and effective to use in patients with renal impairment.     

Management of urinary tract infections

Urinary tract infections (UTIs) are commonly encountered in medical practice and range from asymptomatic bacteruria to acute pyelonephritis. Enterobacteriaceae with E. coli being the most prevalent, are responsible for most commonly acquired uncomplicated UTIs and usually respond promptly to oral antibiotics. In contradistinction, more resistant pathogens cause nosocomially acquired infections which often require parenteral antibiotic therapy. Patients with acute bacterial prostatitis, usually caused by Enterobacteriaceae present with a tender prostate gland and respond promptly to antibiotic therapy. Chronic bacterial prostatitis on the other hand, is a subacute infection characterized by recurrent episodes of bacterial UTI where the patient presents with vague symptoms of pelvic pain and voiding problems. Treatment is protracted and may be frustrating. Nonbacterial prostatitis and chronic pelvic pain syndrome produce symptoms similar to those of chronic bacterial prostatitis. Treatment is not well defined due to their uncertain etiologies. Most episodes of catheter associated bacteruria are asymptomatic, where less than 5% will be complicated by bacteremia. The use of systemic antibiotics for treatment or prevention of bacteruria is not recommended, particularly in the geriatric age group, since it helps select for resistant organisms. Prevention thus remains the best option to control it. Few patients without catheters who have asymptomatic bacteruria develop serious complications and therefore routine antimicrobial therapy is not justified with only two exceptions : before urologic surgery and during pregnancy.     

帕珠沙星治疗尿路感染32例分析

目的: 评价帕珠沙星治疗细菌性尿路感染的安全性、有效性。方法: 以左氧氟沙星为对照药物,在62例受试者中进行随机对照试验。治疗组32例,每日给予帕珠沙星每次300 mg,静脉滴注,每天2次;对照组30例,每日给予左氧氟沙星每次200 mg,静脉滴注,每天2次。疗程7~10天。结果: 治疗组、对照组有效率分别为90.6%和90.0%;痊愈率分别为84.4%和83.3%,细菌清除率分别为93.3%和92.9%;不良反应发生率分别为6.3%和6.7%。两组间差异均无显著性(P>0.05)。结论: 帕珠沙星治疗尿路感染有效、安全,与左氧氟沙星疗效相当。     

国产与进口头孢吡肟治疗急性泌尿系统感染的成本-效果分析

目的比较国产与进口头孢吡肟治疗急性中重度泌尿系统感染的经济效果。方法将122例病例随机分为两组,A组（使用国产药）61例,B组（使用进口药）61例。运用药物经济学方法进行成本-效果分析。结果A、B两组治疗方案的有效率分别为98．36％和96．72％。致病菌清除率均接近100％,两组药物不良反应发生率分别为6．56％和10．47％。两组对比差异均无统计学意义（P〉0．05）。成本-效果比（C／E）分别为4059．64和4625．45。与国产头孢吡肟组相比．进口头孢吡肟组每增加一个单位效果需多花费29309．74元。结论综合考虑,国产头孢吡肟对泌尿系统感染的经济效果优于进口药。