RESUMO
A total of 10,909 puerperal women from 6 different hospitals were screened for bacteriuria by culture of voided midstream urine (MSU), and a significant growth was found in 881 patients (8.1%). In 731 cases the urine was reexamined by using suprapubic aspiration (SPA), and in only 354 (48%) of the samples the diagnosis of bacteriuria was confirmed. The contamination rate of the MSU samples varied from 46 to 69% between the different hospitals, indicating that in the postpartum period positive MSU findings would necessitate more thorough examination in order to confirm the diagnosis of urinary tract infection. In our study, suprapubic aspiration was found to be a simple and acceptable method without any side effects. Confirmed bacteriuria occurred in 3.2% of the women. Operative delivery (Cesarean section, forceps and vacuum extractor delivery), epidural anesthesia and bladder catheterization increased the risk of bacteriuria in the postpartum period. Only 27% of the women with positive bladder urine complained of dysuria and this symptom was significantly more common in women who had been catheterized. 230 patients with confirmed bacteriuria with amoxycillin-sensitive bacterias participated in a randomized short-course treatment trial: 114 women received 3 days treatment with amoxycillin (1.5 g/day), 116 received the traditional 10 days therapy (750 mg amoxycillin/day). Both antibiotic regimens were observed to be effective with a cure rate of 96 and 98%, respectively. Short-course antibiotic treatment should thus be recommended to puerperal women with urinary tract infections since this avoids prolonged drug exposure to the lactating mother.
Assuntos
Amoxicilina/uso terapêutico , Bacteriúria/tratamento farmacológico , Infecção Puerperal/tratamento farmacológico , Bacteriúria/diagnóstico , Escherichia coli/isolamento & purificação , Feminino , Humanos , Klebsiella pneumoniae/isolamento & purificação , Estudos Multicêntricos como Assunto , Gravidez , Proteus mirabilis/isolamento & purificação , Infecção Puerperal/diagnósticoRESUMO
The effects of single evening doses of alpha-methyldopa and placebo have been compared in 40 women with climacteric hot flushes. The study was designed as a double-blind, randomized and cross-over investigation. Of the 24 patients who completed the study, 15 reported that they preferred the alpha-methyldopa treatment (p greater than 0.05). alpha-methyldopa seemed to affect both the severity (p less than 0.05) and the frequency of climacteric hot flushes (p greater than 0.05). It is concluded that alpha-methyldopa is efficacious against climacteric hot flushes when given as single evening doses, but further study is required to answer whether this dosage is as effective as a twice daily regimen.
