Gut-sparing treatment of urinary tract infection in patients at high risk of Clostridium difficile infection.
J Antimicrob Chemother
; 72(2): 522-528, 2017 02.
Article
em En
| MEDLINE
| ID: mdl-27999027
ABSTRACT
BACKGROUND:
Recipients of faecal microbiota transplantation (FMT) in treatment of recurrent Clostridium difficile infection (RCDI) remain at markedly increased risk of re-infection with C. difficile with new antibiotic provocations. Urinary tract infections (UTIs) are common indications for antibiotics in these patients, often resulting in C. difficile re-infection.METHODS:
We present a case series of 19 patients treated with parenteral aminoglycosides for UTI following FMT for RCDI. A 3â day outpatient regimen of once-daily intramuscular administration of gentamicin was used to treat 18 consecutive FMT recipients with uncomplicated UTI. One other patient was treated for a complicated UTI with intravenous amikacin. Profiling of 16S rRNA genes was used to track changes in faecal microbial community structure during this regimen in three patients.RESULTS:
The protocol was highly effective in treating UTI symptoms. None of the patients suffered a re-infection with C. difficile The faecal microbial communities remained undisturbed by treatment with intramuscular administration of gentamicin.CONCLUSIONS:
Despite falling out of favour in recent years, aminoglycoside antibiotics given parenterally have the advantage of minimal penetration into the gut lumen. A brief (3â day) course of parenteral gentamicin was safe and effective in curing UTI in patients at high risk of C. difficile infection without perturbing their gut microbiota.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções Urinárias
/
Amicacina
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Gentamicinas
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Infecções por Clostridium
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Transplante de Microbiota Fecal
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Microbioma Gastrointestinal
/
Antibacterianos
Tipo de estudo:
Etiology_studies
/
Guideline
/
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
/
Female
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Humans
/
Middle aged
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos