Effects of Pipemidic Acid, Phenazopyridine HCL and Sodium Diclofenac on Pain Perception Following Endoscopic Urological Surgery: Double-blinded Randomized-Controlled Trial.

AIM: to evaluate the analgesic effect, the side effects and the safety of analgesics following endoscopic urological procedure. METHODS: eighty patients who underwent endoscopic urological surgery at Kardinah Hospital, Tegal from June to July 2015 were divided into four groups. The experimental group was administered analgesic for 4 days pipemidic acid (A) 400 mg bid, or phenazopyridine (B) 200 mg tid, or sodium diclofenac (C) 50 mg bid and the control (D) group was administered placebo tid for 4 days. The analgesic effects were assessed using Visual Analog Scale (VAS). Association between variables was assessed using Cramers V and Kruskall Wallis. RESULTS: the endoscopic urological procedures consisted of 30 patients for URS, 6 patients for lithotripsy, 17 patients for TURP, 24 patients for removal JJ stent and 3 patients for cystoscopy. The mean age of group A, B, C and D (control) was 50.1 (13.7), 50.7 (14.8), 49.1 (13.4), and 49.6 (14.3) years, respectively, and follow-up period was 7 days. The VAS score in all experimental groups was less than control group on day 1 to 7 following endoscopic urological procedures (p<0.05). In the experimental group, there was no difference between groups B and C (p>0.05). Group A demonstrated a more favourable analgesic effect than B and C (p<0.05). No serious side effects were detected in any of the cases. CONCLUSION: we conclude that oral analgesics are effective for pain relief following endoscopic urological surgery. Pipemidic acid was found to have a superior analgesic effect than phenazopyridine HCl and sodium diclofenac.

Clinical evaluation of herbal coded formulation Cran-off to Urixin in the treatment of urinary tract infection.

Urinary Tract Infections are the largest group of infections after the respiratory tract infections. In 85% of the cases the causative organism is E. Coli. A clinical trial was conducted to evaluate the efficacy of coded herbal formulation "Cranoff" (Test drug) for the treatment of Urinary tract infection comparing with Urixin (Control). One hundred and thirty patients suffering from Urinary tract infection from both groups (Males: 45, mean age: 34±14 and females: 85, mean age: 33±13 year, range: 15-55) were enrolled in the trial and divided in to two groups according to treatment regimens. Cranoff (Test drug) 500mg two capsules and Urixin (Pipemidic Acid Trihydrate JP15) (Control) 400mg capsules twice daily were prescribed for 2-3 weeks. Urinary tract infection was improved in 23 (35.38%) patients out of 65 patients by the use of Cranoff (Test drug), and in 15 (23.07%) patients out of 65 by the use of Urixin (Control drug). Furthermore, there was a significant improvement in Urinary tract infection associated clinical features as compared to Urixin. It is concluded that Cranoff possesses a therapeutic value for the improvement of urinary tract infection and its associated symptoms as compared to Urixin.

Quinolone prophylaxis in transrectal ultrasound guided prostate biopsy: an eight-year single center experience.

We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients' characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%, P < 0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P < 0.001). E. coli was the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.

In vivo activity of ciprofloxacin, ofloxacin, norfloxacin and pipemidic acid against Escherichia coli infections in mice.

The therapeutic efficacy of four quinolones, i.e. ciprofloxacin, ofloxacin, norfloxacin and pipemidic acid, was investigated in experimental infections in mice caused by pipemidic acid-susceptible and -resistant E. coli. For intraperitoneal infections caused by E. coli strain 444 and 23, the efficacy of ciprofloxacin, ofloxacin and norfloxacin was superior to that of pipemidic acid. Furthermore, ciprofloxacin and ofloxacin had higher activity than norfloxacin and pipemidic acid in urinary tract and uterine infections. Serum and uterus levels of ciprofloxacin and ofloxacin in normal mice were higher and more durable than those of norfloxacin.

[Therapy of urinary tract infections. Clinical experience comparing norfloxacin to other quinolones]. / Terapia delle infezioni del tratto urinario. Esperienza clinica di confronto tra la norfloxacina ed altri chinolonici.

The paper examines to treatment of 40 cases of urinary infections and compares the efficacy of pipemidic acid, norfloxacin, cinoxacin and ofloxacin. All these compounds demonstrated a good level of therapeutic efficacy, both in terms of management and effectiveness; in particular, norfloxacin and ofloxacin were preferable to the other compounds since they caused fewer side-effects.

Pipemidic acid, a new treatment for recurrent urinary tract infection in small animals.

A new chemotherapeutic agent, pipemidic acid, was used to treat 14 dogs and 2 cats with recurrent urinary tract infection caused by multiresistent strains of Escherichia coli and Proteus spp. Bacterial culture of the urine after treatment revealed disappearance of the microorganisms in all patients. It is concluded that pipemidic acid is a promising chemotherapeutic agent for urinary tract infections caused by multiresistant E. coli and Proteus spp., with the condition that bacterial culture during the course of treatment is obligatory.

[Comparison of clinical efficacy of lomefloxacin (LFLX, NY-198) and pipemidic acid (PPA) in the treatment of infectious enteritis by a double-blind method. The Japan Research Committee of Lomefloxacin Research Group Enteritis].

The clinical efficacy, safety and usefulness of lomefloxacin (LFLX, NY-198), a new quinolone antimicrobial agent, were compared with those of pipemidic acid (PPA) in the treatment of infectious enteritis (bacillary dysentery, enteropathogenic Escherichia coli enteritis and Campylobacter enteritis) by a double blind method. Daily dosage of LFLX and PPA was 600 mg and 2000 mg, respectively administered orally divided into 4 doses. The duration of the treatment was 5 days. Of 290 cases studied, 100 cases were excluded and 21 cases were dropped from analysis of effectiveness and usefulness. The effectiveness and usefulness was evaluated in 169 cases (LFLX group: 83, PPA group: 86). There was no significance difference between the two groups in any background characteristics. The results obtained were as follows: 1. In 73 symptomatic patients (LFLX group: 35, PPA group: 38) on the day of the beginning of administration, the clinical effect was 91.4% in the LFLX group and 84.2% in the PPA group with no significant difference between the two groups. 2. In a total of 184 strains (LFLX group: 90, PPA group: 94), the bacteriological effects of LFLX (93.3%) was superior to that of PPA (80.9%) with significant difference (p = 0.0153). 3. In 169 evaluable patients, the global clinical effects of LFLX (92.8%) was superior to that of PPA (79.1%) with a significant difference (P = 0.0144). 4. Side effects were observed in 1 (0.7%) of the 141 patients in the LFLX group and none of the 143 patients in the PPA group. Abnormal laboratory test values were noted in 10 (7.6%) of the 132 patients treated with FLLX and 7 (5.1%) of the 136 patients treated with PPA, but they as no significant difference between the two groups. 5. In 169 evaluable patients, the clinical usefulness of LFLX (91.6%) was superior to that of PPA (76.7%) with a significant difference (P = 0.0111). From these results, LFLX is considered to be a clinically useful medicine in the treatment of infectious enteritis including bacillary dysentery.

[Quinolones in the treatment of acute amebic dysentery].

75 patients with acute ame bic dysentery treated with pipemidic acid (PPA) alone and 11 patients with norfloxacin (NFX) alone constituted two study groups and 30 patients treated with metronidazole (MNZ) formed a control group. It was found that the cure rates of PPA, NFX and MNZ were similar (P greater than 0.05), being 98.67%, 100% and 93.33%, respectively; the number of days to become afebrile and to stop abdominal pain in these three groups was also similar (P greater than 0.05); the number of days to stop diarrhea in PPA group was similar to that in NFX (P greater than 0.05), but it was significantly shorter in these two groups than that in the controls (P less than 0.01 and 0.05). As to adverse drug reactions, PPA had the least, NFX was similar to PPA (P greater than 0.05), but MNZ had significantly more than PPA (P less than 0.01).

[Pipemidic acid in the prevention of recurring cystitis in women]. / L'acide pipémidique dans la prophylaxie des cystites récidivantes chez la femme.

The efficacy, safety and acceptability of pipemidic acid in the treatment and the prophylaxis of cystitis in women have been evaluated. After curative treatment, patients received prophylaxis using the compound for a duration of 6 months, and were followed up a further 4 month-period without specific therapy. During the prophylaxis period, no relapse was observed in over 85% of the treated patients. In 15% of cases, a pathogen reappeared along with recurrence of the preexisting symptoms. An increase to 29% of the cases was noted after the withdrawal of the treatment over a month study period. The pathogens involved in the cases of relapse during the prophylaxis period were sensitive to pipemidic acid in 1/3 of cases (6/18 cases), and resistant in 2/3 (12/18 cases) of cases. Those involved in relapses during the observation period were sensitive in 1/2 of the cases (8/16 cases), resistant or intermediate in 1/2 of the cases (8/16 cases). Thus, prophylactic treatment with pipemidic acid has a favorable influence on the number of relapses in patients with recurrent cystitis.

[Preventive treatment of recurrent essential cystitis in women. Comparative study of pipemidic acid and placebo in a daily dose of 200 mg. for 6 months]. / Traitement préventif de la cystite essentielle récidivante de la femme. Etude comparative de l'acide pipémidique contre placebo en prise quotidienne de 200 mg pendant 6 mois.

Seventy female patients presenting with frequent (less than or equal to 4 episodes per year) recurrent essential cystitis participated in a comparative, double-blind placebo-controlled study of prophylactic treatment with Pipram. Treatment was administered at the dose of 200 mg in the evening at bedtime for 6 months, followed by a post-treatment phase of 6 months. Four episodes of cystitis occurred during the first 6 months in the Pipram group and 11 in the placebo group; a single episode of infection was observed in the placebo group over the entire observation period (1/2 year). The difference between the two groups, Pipram and placebo, was statistically significant at 6 months and at 1 year. The relative risk of infection in the placebo group was 3.02 at 6 months and 3.56 at 12 months. The bacteria responsible for reinfection during and after treatment were resistant to pipemidic acid in 2 out of 2 cases in the Pipram group and in 2 out of 7 cases in the placebo group. Treatment was well tolerated: 2 discontinuations of treatment because of benign side effects in the Pipram group.

[Quinolone-resistant Escherichia coli in the health area of a 650-bed hospital]. / Escherichia coli resistente a quinolonas en el area sanitaria de un hospital de 650 camas.

Report of a retrospective study to evaluate susceptibility of Escherichia coli to quinolones covering the March-December 1992 interval. During this time, intra and extra-hospital strains were indistinctly studied in patients with urinary infections seen in a health district serving a total of 200.000 inhabitants. Resistance to Pipemidic acid, Norfloxacin and Ciprofloxacin was evaluated. The values found were 14.8% resistance to Pipemidic acid, 11.1% to Norfloxacin and 8.5% to Ciprofloxacin. It seems necessary to develop and apply methods addressed to minimize the appearance of quinolone resistance, which should be implemented in order to preserve the usefulness of these drugs.

[Clinical effectiveness of pipemidic acid on gonorrhoeal urethritis].

Twenty cases of gonorrhoeal urethritis were orally treated with pipemidic acid (PPA). The results are as follows. The clinical effect of PPA was excellent in 9 cases and good in 6 cases, the efficacy rate being 75%. The usefulness of PPA was satisfactory in 12 cases (60%). No side effects were observed. The minimal inhibitory concentrations against 14 isolated Neisseria gonorrhoeal strains ranged from 0.78 to 3.13 micrograms/ml with a median value of 1.56 micrograms/ml. A beta-lactamase-producing strain was observed among the 14 strains and the case infected by this strain was successfully treated with PPA. These results indicate that PPA is a useful drug for the treatment of gonorrhoeal urethritis.

[Clinical studies with antimicrobic agent "Dolcol" for chronic prostatitis].

Chronic prostatitis is possibly the most common infectious disease in middle-aged men. Clinical investigation was made on 24 outpatients with chronic prostatitis at our department, during the period of October, 1983 to August, 1984. The diagnostic criterion of the prostatitis was detection of more than ten leukocytes per high power field on microscopic examination of the expressed prostatic secretion and urine after prostatic massage. Twenty-four patients with chronic prostatitis were treated with 2 tablets of Dolcol (Pipemidic acid, PPA) three times daily for 7-30 days. The effectiveness was evaluated by improvement of subjective symptoms and objective findings. The results of the therapy with PPA on chronic prostatitis were excellent in 8 patients (33.3%), good in 10 (41.7%), fair in 2 (8.3%), and poor in 4 (16.7%). The effective rate was 83.3%, while no side effects were noted. Therefore, PPA was suggested to be effective against chronic prostatitis.

[Comparative studies of DL-8280 and pipemidic acid in complicated urinary tract infections by double-blind method].

The clinical efficacy, safety and usefulness of DL-8280 for the treatment of complicated urinary tract infections were compared with those of pipemidic acid (PPA) by a double-blind method. DL-8280 and PPA were orally administered at a daily dose of 600 mg (t.i.d.) and 2.0 g (q.i.d.) for 5 days, respectively. Of the 311 patients who received DL-8280 or PPA, clinical efficacy, safety and usefulness were evaluated in 228 patients (DL-8280, 115; PPA, 113), 306 patients (DL-8280, 153; PPA, 153) and 250 patients (DL-8280, 124; PPA, 126), respectively. There was no significant difference in the background characteristics between the two groups. In the DL-8280 group the overall clinical efficacy was excellent in 39.1% and moderate in 41.7%, the effectiveness rate being 80.9%, whereas in the PPA group it was excellent in 23.9% and moderate in 33.6%, the effectiveness rate being 57.5%. The efficacy in the DL-8280 group was significantly higher than that in the PPA group (P less than 0.001). According to classification by the type of infection, the overall clinical efficacy of DL-8280 in groups except group 2 (monomicrobial infection, post prostatectomy) and group 3 (monomicrobial infection, upper urinary tract infection) was superior to that of PPA, the difference being significant. Pyuria was cleared or improved in 59.1% of the patients treated with DL-8280 and in 46.0% of the patients with PPA. The difference was not significant. Bacteriuria was eliminated in 76.5% in the DL-8280 group and in 50.4% in the PPA group. DL-8280 demonstrated a significantly higher response than PPA (P less than 0.001). Of the bacteria isolated from the DL-8280 group and PPA group 89.0% and 72.1%, respectively, were eradicated after the treatment, a significant difference being observed between the two groups (P less than 0.001). The clinical efficacy evaluated by the doctor in charge was excellent in 46.1% and good in 37.4% of the patients treated with DL-8280 and excellent in 26.5% and good in 34.5% of the patients treated with PPA, the intergroup difference in the efficacy being significant (P less than 0.001). The evaluation of usefulness of DL-8280 and PPA was "satisfactory" for 71.8% and 47.6%, respectively, the difference being significant (P less than 0.001). Side effects were observed in 11 patients (7.2%) in the DL-8280 group and in 12 patients (7.8%) in the PPA group, but none were serious.(ABSTRACT TRUNCATED AT 400 WORDS)

[Long-term non-deforming urinary infections in childhood. 2. Proposed treatment and results]. / Le infezioni urinarie di lunga durata non malformativa in età pediatrica. II. Proposte di trattamento e risultati.

In the second part of the Authors work, they report the results obtained in the treatment of 85 female children with recurrent non malformative urinary tract infections. The first group of 15 female children had been treated with phenoxybenzamine and urinary chemyotherapycs with little satisfaction. The other two groups, both of which consisted of 35 children, one group was treated with only chemyotherapycs and the other with chemyotherapycs associated to oxybutynin chloride. The best results were obtained in the last group regarding the improvement of the symptoms and earlier and higher incidence of sterilization of the urine. At the same time in this group the maximum cystometric capacity and vesical compliance were brought back to normal and the detrusorial instability disappeared.

[A clinical trial of the preparation palin in women with refractory colpitis]. / Klinichno izpitvane na preparata palin pri zheni s uporiti kolpiti.

The authors carried out clinical trial of the preparation Palin (pipemidinic acid) on 43 women with persistent colpitis after preliminary testing. There was negative microbiological finding in 67% of women. The results of the authors differed from those of other authors, since Palin was used mainly in women with chronic colpitis resistant to routine treatment. Minimal side effects were found. Usage of Palin is recommended in women with colpitis, caused by: E. coli, Enterococcus, Klebsiella and mixed aerobic flora.