Urinary infection Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2017;39(10):534-540
The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study.
Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS.
We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria.We didn’t observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group.
The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.
Summary
Rev Bras Ginecol Obstet. 2017;39(10):534-540
The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study.
Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS.
We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria.We didn’t observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group.
The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.
Summary
Rev Bras Ginecol Obstet. 2000;22(10):647-651
DOI 10.1590/S0100-72032000001000008
Purpose: to study the effects of ciprofloxacin on abortion percentage, maternal weight gain during pregnancy, fetal and maternal death, gross fetal malformation, newborn number, weight and neurological reflexes. Methods: we used 30 Wistar rats, divided into three groups: D50-treated (ciprofloxacin, 50 mg/kg); D100-treated (ciprofloxacin 100 mg/kg) and control group which received physiological saline per os, from the 1st to the 7th day after mating. We studied abortion percentage, maternal weight gain during pregnancy, fetal and maternal death, gross fetal malformation, newborn number and weight at 1st, 3rd, 5th and 10th day of life and newborn neurological reflexes at 1st, 3rd, 5th and 10th day of life. Results: there was no difference between groups in the number of rats that became pregnant. The same was found for maternal weight gain and newborn number. There was a difference in newborn mean weight on day 3rd, 5th and 10th (p = 0.006, 0.01 and 0.03, respectively). The D100 newborn group was the one with less weight gain up to the 10th day of life. We found a significant difference (p = 0.002) in the newborn orientation reflex on the 1st day of life, that disappeared afterwards. No abortion or gross malformation was found in this study. Conclusions: ciprofloxacin modified the newborn weight and reflex on the first days of life. In conclusion, we consider that the use of ciprofloxacin should be restricted during the pregnancy.
Summary
Rev Bras Ginecol Obstet. 2000;22(10):647-651
DOI 10.1590/S0100-72032000001000008
Purpose: to study the effects of ciprofloxacin on abortion percentage, maternal weight gain during pregnancy, fetal and maternal death, gross fetal malformation, newborn number, weight and neurological reflexes. Methods: we used 30 Wistar rats, divided into three groups: D50-treated (ciprofloxacin, 50 mg/kg); D100-treated (ciprofloxacin 100 mg/kg) and control group which received physiological saline per os, from the 1st to the 7th day after mating. We studied abortion percentage, maternal weight gain during pregnancy, fetal and maternal death, gross fetal malformation, newborn number and weight at 1st, 3rd, 5th and 10th day of life and newborn neurological reflexes at 1st, 3rd, 5th and 10th day of life. Results: there was no difference between groups in the number of rats that became pregnant. The same was found for maternal weight gain and newborn number. There was a difference in newborn mean weight on day 3rd, 5th and 10th (p = 0.006, 0.01 and 0.03, respectively). The D100 newborn group was the one with less weight gain up to the 10th day of life. We found a significant difference (p = 0.002) in the newborn orientation reflex on the 1st day of life, that disappeared afterwards. No abortion or gross malformation was found in this study. Conclusions: ciprofloxacin modified the newborn weight and reflex on the first days of life. In conclusion, we consider that the use of ciprofloxacin should be restricted during the pregnancy.
Summary
Rev Bras Ginecol Obstet. 2002;24(7):471-477
DOI 10.1590/S0100-72032002000700007
Purpose: to assess the diagnostic and therapeutic aspects and the complications of symptomatic urinary tract infections (UTI) during pregnancy of patients who were hospitalized. Methods: a total of 136 pregnant women with a clinical diagnosis of pyelonephritis were studied. The studied parameters were: age and parity of patients, gestational age of diagnosis, epidemiologic aspects, laboratory evaluation for UTI, treatment and clinic evolution, prophylaxis and complications. Results: pyelonephritis was diagnosed at the same proportions at all gestational ages. The incidence of UTI was higher among primigravidae. Only 29.3% of the pregnant women had a previous history of UTI; 57.0% were anemic and 93.0% had altered urinalysis. Escherichia coli was the most prevalent uropathogen (75.8% of cases), with low percentages of sensitivity to ampicillin (60.6%) and high percentages of sensitivity to cefuroxime (95,5%). The highest rate of clinical improvement was obtained for the pregnant women treated with cefuroxime (95.7%). Prophylaxis was needed in 11.0% of the patients. Preterm labor occurred in 33.3% of the pregnant women who delivered in our service and preterm delivery occurred in 18.9%. Conclusions: the present results support the need for an early diagnosis and effective treatment of UTI in pregnant women in order to prevent the frequent occurrence of perinatal complications such as premature labor and delivery. We emphasize the need of a periodical evaluation of the pattern of sensitivity of the etiologic agents to the antimicrobials allowed for use during pregnancy, with cefuroxime being adopted as the antibiotic of choice for the treatment of UTI during pregnancy.
Summary
Rev Bras Ginecol Obstet. 2002;24(7):471-477
DOI 10.1590/S0100-72032002000700007
Purpose: to assess the diagnostic and therapeutic aspects and the complications of symptomatic urinary tract infections (UTI) during pregnancy of patients who were hospitalized. Methods: a total of 136 pregnant women with a clinical diagnosis of pyelonephritis were studied. The studied parameters were: age and parity of patients, gestational age of diagnosis, epidemiologic aspects, laboratory evaluation for UTI, treatment and clinic evolution, prophylaxis and complications. Results: pyelonephritis was diagnosed at the same proportions at all gestational ages. The incidence of UTI was higher among primigravidae. Only 29.3% of the pregnant women had a previous history of UTI; 57.0% were anemic and 93.0% had altered urinalysis. Escherichia coli was the most prevalent uropathogen (75.8% of cases), with low percentages of sensitivity to ampicillin (60.6%) and high percentages of sensitivity to cefuroxime (95,5%). The highest rate of clinical improvement was obtained for the pregnant women treated with cefuroxime (95.7%). Prophylaxis was needed in 11.0% of the patients. Preterm labor occurred in 33.3% of the pregnant women who delivered in our service and preterm delivery occurred in 18.9%. Conclusions: the present results support the need for an early diagnosis and effective treatment of UTI in pregnant women in order to prevent the frequent occurrence of perinatal complications such as premature labor and delivery. We emphasize the need of a periodical evaluation of the pattern of sensitivity of the etiologic agents to the antimicrobials allowed for use during pregnancy, with cefuroxime being adopted as the antibiotic of choice for the treatment of UTI during pregnancy.