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1.
Urologiia ; (5): 27-30, 2019 Dec.
Artigo em Russo | MEDLINE | ID: mdl-31808628

RESUMO

AIM: To determine whether fosfomycin can be used in treatment of women with acute uncomplicated cystitis in the postpartum period. MATERIALS AND METHODS: The results of treatment of acute uncomplicated cystitis in 51 patients in the postpartum period were retrospectively evaluated. All patients received a single dose 3 g of fosfomycin. RESULTS: In order to determine clinical efficiency, in all cases laboratory tests were performed prior to and 3 days after treatment. A degree of pain syndrome, the number of voids and urgent episodes were also evaluated. Urine culture was studied before and 7 days after taking fosfomycin. There was a decrease in the number of leukocytes and erythrocytes in urine, number of voids, including urgent episodes. A normalization of urine flora after a single dose of the fosfomycin was noted. DISCUSSION: In our research in the repeated analysis of urine culture, the number of bacteria was lower than 104 in all cases, and there was also decrease in the number of voids and intensity of pain syndrome. CONCLUSION: The treatment of acute uncomplicated cystitis in women in the early postpartum period has its own characteristics. A single dose of fosfomycin allows to avoid long-term use of the antibiotic and to continue breastfeeding, which is required for the treatment of this disease in lactating women. One of the medicine used in AAC is Fosfomycin Esparma, which has a high safety profile. The use of high-quality antibacterial therapy in these patients to give possibility to avoid complications.


Assuntos
Antibacterianos/uso terapêutico , Cistite/tratamento farmacológico , Fosfomicina/uso terapêutico , Doença Aguda , Cistite/diagnóstico , Feminino , Humanos , Lactação , Período Pós-Parto , Estudos Retrospectivos , Resultado do Tratamento , Infecções Urinárias
2.
Urologiia ; (5): 64-71, 2019 Dec.
Artigo em Russo | MEDLINE | ID: mdl-31808635

RESUMO

AIM: A comparative evaluation of the efficacy and safety of Canephron N and Cystone as monotherapy in women with acute uncomplicated cystitis and antibiotic allergy or intolerance was performed. MATERIALS AND METHODS: A prospective, randomized, controlled study of drug Canephron N as monotherapy for acute uncomplicated cystitis in 51 women with a history of antibiotic allergy or intolerance was carried out in 3 urological centers in Perm from 2016 to 2019. In the main group, patients received Canephron N for 30 days, while in comparison group, Cystone was prescribed. The Acute Cystitis Symptom Score (ACSS), microscopic study of urine sediment, urine culture and other methods were used. Results were evaluated 3, 6, 30 days and 1 year after the start of treatment. RESULTS: In the main group, monotherapy with Canephron N for 30 days resulted in a decrease in the total ACSS score from the baseline 12.9 to 0.3 points, while in Cyston group, changes of ACSS score were less pronounced, from baseline 12.8 to 1.4 points (p<0.01). Clinical cure rate in the main and comparison group was 88.5% and 68%, respectively. In another 3.8% and 1% of patients in the main and comparison group, an improvement was seen. The number of patients with leukocyturia in the Canephron N group decreased to 11.5% compared to 28% in Cyston group (p>0.05). Bacteriuria rate in the main group was 7.7%, which was less than in the comparison group (20%, p>0.05). Number of sick days in the main group was 4.9+/-0.4, compared to 7.4+/-0.6 days in Cyston group. In the Canephron N group, 1-year recurrence rate was only 7.7%, while in the Cyston group the recurrence was seen in 16% of patients. CONCLUSION: According to the results, Canephron N is an effective and safe drug as monotherapy for acute uncomplicated cystitis, and can be considered as drug of choice for the treatment of women with antibiotic allergy or intolerance.


Assuntos
Bacteriúria/tratamento farmacológico , Cistite/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Doença Aguda , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Bacteriúria/microbiologia , Cistite/microbiologia , Feminino , Humanos , Hipersensibilidade , Estudos Prospectivos , Resultado do Tratamento
3.
Urologiia ; (4): 20-25, 2019 Sep.
Artigo em Russo | MEDLINE | ID: mdl-31535800

RESUMO

AIM: To evaluate the efficacy and safety of the antibacterial drug fosfomycin trometamol (Fosfomycin Esparma) in women of reproductive age with acute uncomplicated cystitis. MATERIALS AND METHODS: In order to assess the efficacy and safety of using fosfomycin trometamol (Fosfomycin Esparma), a prospective, non-randomized, uncontrolled study involving 32 women with acute uncomplicated cystitis was carried out. The average patients age was 27.3+/-3.1 years. Before the study, all women underwent a general clinical, bacteriological, and ultrasound examination. Inclusion criteria was the presence of pathognomonic symptoms of acute uncomplicated cystitis. Exclusion criteria were as following: complicated urinary tract infection, anatomical and functional disorders of the urinary tract, comorbidities. All patients were prescribed a study drug at a dose of 3 g, once. The efficiency of therapy was evaluated on days 3 and 14 after administration of Fosfomycin Esparma based on clinical and microbiological cure and safety. RESULTS: The only bacterial pathogen isolated from the urine was E. coli. In 4 cases (12.5%) strains produced extended-spectrum -lactamase. The sensitivity of E. coli to fosfomycin, piperacillin/tazobactam, amikacin and meropenem was 100%. A resistance to ampicillin was 15.6%, compared to 9.4% for levofloxacin and norfloxacin and 12% for cefotaxime, ceftazidime, cefpoxin. By the 3rd day after receiving fosfomycin, the symptoms of cystitis were resolved in all patients. On day 14, according to the results of the urine culture, there was no growth of bacteria. During the follow-up period, no significant side effects was detected. CONCLUSION: Our study showed that antibacterial drug Fosfomycin Esparma in women of reproductive age with acute uncomplicated cystitis is effective and safe. Maintaining a high sensitivity to fosfomycin allows us to recommend this drug as an empirical antibiotic therapy in this cohort of patients.


Assuntos
Antibacterianos/uso terapêutico , Cistite/tratamento farmacológico , Fosfomicina/uso terapêutico , Infecções Urinárias , Escherichia coli , Feminino , Humanos , Estudos Prospectivos
4.
J Vet Intern Med ; 33(5): 2117-2123, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400046

RESUMO

BACKGROUND: Urethral obstruction (UO) is a common complication of feline idiopathic cystitis (FIC). Robust treatment recommendations to prevent its recurrence are scarce. OBJECTIVES: To evaluate meloxicam treatment for prevention of clinical recrudescence in male cats with obstructive FIC. ANIMALS: Fifty-one client-owned cats. METHODS: Prospective, randomized clinical trial. Every male cat with FIC-associated UO was deemed eligible for the study and was recruited during hospitalization. After discharge, cats were treated with phenoxybenzamine and alprazolam for 2 weeks, with (24 cats) or without (27 cats) low-dose meloxicam (0.025 mg/kg/day PO) and monitored for 6 months. RESULTS: Cumulative number (%) of cats with recurrent UO at 10 days, 1-, 2-, and 6-months after discharge was 1 (2%), 2 (4%), 4 (8%), and 8 (16%), respectively. Overall, 12 (24%) cats experienced signs of recurrent FIC within 6 months, with (8 cats) or without (4 cats) concurrent UO. No difference in the cumulative incidence of UO within 6 months was detected with addition of meloxicam (odds ratio [95% confidence interval], 0.63 [0.13-2.97]; P = .70). All cats were alive at 6 months. CONCLUSIONS AND CLINICAL IMPORTANCE: No clinical benefit was detected with the addition of low-dose meloxicam to phenoxybenzamine and alprazolam treatment for 2 weeks after discharge. Nevertheless, this study was underpowered to identify potential differences, and its findings must be corroborated in larger studies.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Doenças do Gato/prevenção & controle , Cistite/veterinária , Meloxicam/uso terapêutico , Obstrução Uretral/veterinária , Antagonistas Adrenérgicos alfa/uso terapêutico , Alprazolam/uso terapêutico , Animais , Doenças do Gato/tratamento farmacológico , Gatos , Protocolos Clínicos , Cistite/tratamento farmacológico , Cistite/prevenção & controle , Hipnóticos e Sedativos/uso terapêutico , Masculino , Fenoxibenzamina/uso terapêutico , Estudos Prospectivos , Recidiva , Obstrução Uretral/tratamento farmacológico , Obstrução Uretral/prevenção & controle
5.
Eur J Pharmacol ; 861: 172593, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31401154

RESUMO

We focused on the cyclophosphamide-induced hemorrhagic cystitis (100 mg/kg/day intraperitoneally throughout three days) as a particular NO-system disturbance, and therapy possibilities. We demonstrated that it may be attenuated by subsequent administration of the NOS substrate L-arginine (100 mg/kg/day intraperitoneally), aggravated by NOS-blocker L-NAME (5 mg/kg/day intraperitoneally), all influenced by the stable gastric pentadecapeptide BPC 157 (10 µg/kg/day, 10 ng/kg/day, intraperitoneally or perorally, in drinking water). Regularly, cyclophosphamide dose- and time-dependently induced severe hemorrhagic cystitis lesions, gross lesions, and corresponding urothelial necrosis, vesical edema, erosion, hemorrhage, inflammation, and ulceration, microscopically. The bladder wet weight dramatically increased. Functionally, already after first cyclophosphamide administration, there is an increased leak point pressure. Until the second cyclophosphamide administration, L-arginine consistently attenuated regular cyclophosphamide-induced severe hemorrhagic cystitis lesions, grossly and microscopically, but not functionally. L-NAME aggravated these lesions and eradicated beneficial effect of L-arginine when combined. BPC 157 administration after cyclophosphamide, given in either dose or in either regimen markedly attenuated all cyclophosphamide lesions, grossly, microscopically. The increase of the bladder wet weight was consistently attenuated. Functionally, increased leak point pressure was reversed to the values noted in normal rats. The similar findings were noted in rats that received BPC 157 together with L-NAME or L-arginine, given alone or combined. Thus, the lesions are NO-related based on the administration of L-NAME as well as administration of L-arginine, and their mutual interaction, and counteraction by BPC 157 application. Likewise, we reveal new therapeutic possibilities, emphasizing stable gastric pentadecapeptide BPC 157 and L-arginine, versus L-NAME in rats underwent cyclophosphamide-induced cystitis.


Assuntos
Arginina/farmacologia , Ciclofosfamida/efeitos adversos , Cistite/complicações , Cistite/tratamento farmacológico , Hemorragia/complicações , NG-Nitroarginina Metil Éster/farmacologia , Fragmentos de Peptídeos/farmacologia , Proteínas/farmacologia , Animais , Antiulcerosos/farmacologia , Antiulcerosos/uso terapêutico , Arginina/uso terapêutico , Feminino , NG-Nitroarginina Metil Éster/uso terapêutico , Fragmentos de Peptídeos/uso terapêutico , Proteínas/uso terapêutico , Ratos , Ratos Wistar
6.
Rev Esp Quimioter ; 32(4): 375-378, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31328907

RESUMO

OBJECTIVE: Treatment of uncomplicated urinary tract infections in primary care is generally empirical without requesting urine culture and based on biased resistance data collected from selected patients, most of them having risk factors for the isolation of resistant microorganisms. In order to overcome the lack of information on the real resistance rates in uncomplicated UTI, we compared antimicrobial phenotype and genotype of Escherichia coli isolated from pregnant women with asymptomatic bacteriuria (culture always performed) with those from women with uncomplicated acute cystitis (culture rarely performed) of different age groups. METHODS: Between September 2017 and March 2018, 103 urines were randomly collected from pregnant women aged between 16 and 47 with asymptomatic bacteriuria (AB) (n=42), not hospitalized women in the same age range with uncomplicated acute cystitis (UAC) (n=31) and women older than 47 not hospitalized with UAC (n=30). Bacteria identification was performed using mass spectrometry and the antibiogram by broth microdilution. Genetic typification was carried out by pulsed-field gel electrophoresis. RESULTS: There are no significant differences between the groups of patients in the antibiotic susceptibility. Likewise, as expected, a wide genetic diversity is observed among the strains of E. coli studied without significant differences between the three groups. CONCLUSIONS: We propose a simple model that could provide better guidance for selection of empirical antimicrobial therapy for non-pregnant women with UAC than do generic hospital antibiogram data based on reliably extrapolating the susceptibility data of strains isolated from pregnant women with AB as representation of women with community-acquired UAC.


Assuntos
Antibacterianos/uso terapêutico , Infecções Assintomáticas , Infecções por Escherichia coli , Escherichia coli/efeitos dos fármacos , Complicações Infecciosas na Gravidez , Infecções Urinárias , Doença Aguda , Adolescente , Adulto , Bacteriúria/microbiologia , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Cistite/tratamento farmacológico , Cistite/microbiologia , Farmacorresistência Bacteriana , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/urina , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Fenótipo , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/microbiologia , Complicações Infecciosas na Gravidez/urina , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Infecções Urinárias/urina , Adulto Jovem
7.
Urologiia ; (3): 66-71, 2019 Jul.
Artigo em Russo | MEDLINE | ID: mdl-31356015

RESUMO

INTRODUCTION: Lower urinary tract infections (LUTI) are one of the most common diseases among women. The risk of LUTI increases with the onset of peri- and postmenopause. Vulvovaginal atrophy occurs in 30% of women aged 55 years and 75% of women aged 70 years. Currently, local hormone therapy is the main method of its treatment. However, different variants of complex therapy are also used. MATERIALS AND METHODS: The study included 60 women aged with the diagnosis: "Postmenopausal atrophic vaginitis. Chronic recurrent bacterial cystitis in the acute stage". The patients were divided into 2 groups of 30 people. In group 1 was carried out etiotropic antibiotic therapy in combination with local use of single-agent preparation or estriol for 3 months. In group 2, the patients received antibiotics in combination with Triozhinal for 3 months. The effectiveness was monitored on the 1st and 7th day of therapy, as well as 3 months after the start of treatment. RESULTS: At admission in both groups there were signs of vulvovaginal atrophy and exacerbation of chronic cystitis. Complex therapy with Triozhinal, containing lyophilized culture of lactobacilli L. casei rhamnosus Doderleini, contributed to the normalization of PH, restoration of vaginal biocinosis, and, consequently, reduce the severity of complaints of dryness and burning in the vagina, dyspareunia. Thus, despite the reduction of symptoms in the majority of women, the proportion of such patients in group 2 was higher and amounted to 96.7% against 83.3% in group 1. Supportive reception of the drug for 3 months. it allowed to preserve the normocinosis of the vagina until the restoration of its trophic, as well as to reduce the frequency of bacteriuria and leukocyturia by 20% compared with the results of group 1, and to significantly reduce the number of relapses of infection (p<0.05). CONCLUSION: Triozhinal improves the results of treatment of recurrent urinary infection in women with vulvovaginal atrophy in peri- and postmenopausal and can be recommended for use in combination therapy.


Assuntos
Cistite , Probióticos , Infecções Urinárias , Idoso , Atrofia , Cistite/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Probióticos/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Vagina
9.
Urologiia ; (2): 9-14, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31162894

RESUMO

INTRODUCTION: Currently, chronic recurrent cystitis is one of the most important problems in urology. Considering the role of immune status disorders in the pathogenesis of inflammatory diseases, the use of immunocorrective drugs as part of the complex therapy is of particular relevance. AIM: to study the efficiency of therapy for chronic recurrent bacterial cystitis in combination with immunomodulators (Galavit). MATERIALS AND METHODS: A total of 60 women with acute stage of chronic recurrent bacterial cystitis were examined. The patients were randomized into 2 groups of 30 patients. In the control group, standard antibiotic therapy was administered. In the treatment group, patients received Galavit in combination with standard therapy. All patients were followed-up on the 1st, 5th and 10th day. Voiding diaries, chronobiological status and pain severity using a 5-point scale were evaluated. In addition, complete blood count, urinalysis, urine culture and enzyme immunoassay for determination of serum level of interleukin (IL) 1, IL-6, tumor necrosis factor (TNF-) were analyzed. A number of recurrences after 3 months of therapy was assessed. RESULTS: Complex therapy in combination with Galavit in women with acute stage of chronic bacterial cystitis allows to decrease in desynchronosis by 20%, reduce pain by 2.5 times, frequency of urination by 1.7 times, the number of urgent voids and night urination by 2.4 and 5 times, respectively, by the 5th day of therapy. In the group of patients receiving immunomodulators a significantly more pronounced decrease in the level of IL-1, IL-6, TNF- and CRP was noted. During 3 months of follow-up, there were 2 recurrences in the control group and no recurrences in treatment group (10%). CONCLUSION: The use of Galavit in the treatment of women with chronic recurrent bacterial cystitis has pathogenetic basis. A clear advantage of the drug is more rapid relief of symptoms, normalization of laboratory parameters, recovery of chronorhythms and the achievement of clinical remission.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Cistite/tratamento farmacológico , Luminol/análogos & derivados , Infecções Urinárias/tratamento farmacológico , Antibacterianos/administração & dosagem , Doença Crônica , Quimioterapia Combinada , Feminino , Humanos , Luminol/administração & dosagem , Luminol/uso terapêutico , Recidiva
10.
Urol Int ; 103(1): 41-48, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31117097

RESUMO

OBJECTIVES: The purpose of the study was to compare the efficacy of a product containing cranberry and propolis (DUAB) to placebo for reducing frequency of cystitis in women with recurrent acute cystitis. METHOD: A multicenter, placebo-controlled, randomized study of women aged >18 years with at least 4 episodes of cystitis in the previous 12 months was performed. The number of cystitis episodes over a 6-month follow-up was the primary end point. RESULTS: Forty-two women were included in the cranberry + propolis group, and 43 women were in the placebo group. The mean age was 53 ± 18 years, with 6.2 ± 3.6 cystitis episodes in the previous year, with no differences between the 2 groups. The mean number of infections was lower in the propolis + cranberry group (respectively, 2.3 ± 1.8 vs. 3.1 ± 1.8). The total number of cystitis episodes in the first 3 months was lower in the propolis + cranberry group (0.7 ± 1.1 vs. 1.3 ± 1.1, p = 0.0257) after adjusting for water consumption. The mean time to onset of the first urinary tract infection (UTI) was also significantly longer in the propolis + cranberry group (69.9 ± 45.8 days vs. 43.3 ± 45.9, p = 0.0258). Tolerance to the treatments was good and comparable in both groups. CONCLUSIONS: We demonstrate for the first time that cranberry and propolis supplementation significantly reduces the incidence of UTIs during the first 3 months and delays the onset of an episode of cystitis.


Assuntos
Cistite/tratamento farmacológico , Infecções por Escherichia coli/prevenção & controle , Extratos Vegetais/administração & dosagem , Própole/administração & dosagem , Infecções Urinárias/prevenção & controle , Vaccinium macrocarpon/química , Adulto , Idoso , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Recidiva , Resultado do Tratamento , Adulto Jovem
12.
Prim Care ; 46(2): 191-202, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31030820

RESUMO

Urinary tract infections, including cystitis and pyelonephritis, are the most common bacterial infection primary care clinicians encounter in office practice. Dysuria and frequency in the absence of vaginal discharge and vaginal irritation are highly predictive of cystitis. Urine culture is recommended for the diagnosis and management of pyelonephritis, recurrent urinary tract infection, and complicated urinary tract infections. Antibiotics targeted toward Escherichia coli, Proteus, Klebsiella, and Staphylococcus saprophyticus are the recommended treatment. The duration of treatment varies by specific drug and type of infection, ranging from 3 to 5 days for uncomplicated cystitis to 7 to 14 days for pyelonephritis.


Assuntos
Antibacterianos/uso terapêutico , Cistite , Pielonefrite , Cistite/diagnóstico , Cistite/tratamento farmacológico , Cistite/prevenção & controle , Disuria/etiologia , Feminino , Humanos , Pielonefrite/diagnóstico , Pielonefrite/tratamento farmacológico , Pielonefrite/prevenção & controle , Fatores de Risco , Prevenção Secundária , Infecções Urinárias/classificação
13.
Neurourol Urodyn ; 38(4): 1044-1052, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30869827

RESUMO

AIMS: The main goal of our study was to investigate whether blebbistatin would prevent the cyclophosphamide (CYP)-induced changes in cystometric and inflammatory parameters indicating the development of bladder inflammation and bladder overactivity. As the nature of CYP-induced urotoxicity is inflammatory, we assume that agents presenting an anti-inflammatory potential, such as blebbistatin, are worth special attention. MATERIALS AND METHODS: The experiments were carried out in female Wistar rats. Surgical procedures, cystometric investigations, measurements of bladder edema and urothelium thickness as well as biochemical analyses were performed according to the published literature. RESULTS: As expected, an acute administration of CYP (200 mg/kg, intraperitoneally) induced changes in the cystometric parameters and the levels of the tested biomarkers (ie, interleukin 1-ß, interleukin 6, interleukin 10, tumor necrosis factor-α, nerve growth factor, brain-derived neurotrophic factor, heparin-binding epidermal growth factor-like growth factor, insulin-like growth factor-binding protein 3, C-X-C motif chemokine 10, orosomucoid-1, Tamm-Horsfall protein, hemopexin, and occludin), indicating the development of bladder overactivity and bladder inflammation, respectively. These changes were accompanied by bladder edema and increased urothelium thickness. Intravesical infusion of blebbistatin for 7 days (125 nmol/day) prevented all symptoms of the CYP-induced urotoxicity. CONCLUSIONS: Blebbistatin might be a promising novel agent for the treatment of bladder dysfunctions, like CYP-induced hemorrhage cystitis or bladder overactivity, since it diminished the increased urinary bladder levels of proinflammatory markers and normalized the concentrations of the anti-inflammatory ones. This effect was accompanied by amelioration of bladder edema and permeability, and normalization of both urothelium thickness and values of the cystometric parameters.


Assuntos
Cistite/tratamento farmacológico , Compostos Heterocíclicos de 4 ou mais Anéis/uso terapêutico , Bexiga Urinária Hiperativa/tratamento farmacológico , Bexiga Urinária/efeitos dos fármacos , Administração Intravesical , Animais , Ciclofosfamida , Cistite/induzido quimicamente , Cistite/fisiopatologia , Modelos Animais de Doenças , Feminino , Compostos Heterocíclicos de 4 ou mais Anéis/farmacologia , Ratos , Ratos Wistar , Resultado do Tratamento , Bexiga Urinária/fisiopatologia , Bexiga Urinária Hiperativa/induzido quimicamente , Bexiga Urinária Hiperativa/fisiopatologia
14.
Support Care Cancer ; 27(11): 4273-4281, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30874926

RESUMO

PURPOSE: The aim of the present study was to evaluate the potential uroprotective effect of pantoprazole (PPZ) in a mouse model of cyclophosphamide (CP)-induced hemorrhagic cystitis (HC) due to its antioxidant and anti-inflammatory properties. METHODS: Balb/c mice received a single intraperitoneal (i.p.) injection of CP (300 mg/kg) to induce HC. PPZ (20, 50, and 100 mg/kg/day;i.p.) was administered for 3 consecutive days before the induction of HC. Mesna (30 mg/kg;i.p.) was administered 20 min before, 4 and 8 h after CP injection to compare the protective effects of PPZ. After 24 h of HC induction, the bladders were removed for functional studies, biochemical analyses, and histopathological examination. RESULTS: In vitro contractility studies demonstrated that CP-induced HC decreased the responsiveness of detrusor muscle strips to acetylcholine (ACh), which was reversed by PPZ pretreatment at all doses tested. However, mesna treatment was not able to improve responsiveness to ACh. Biochemical analyses showed that CP caused significant elevation of malondialdehyde (MDA), reduction of total glutathione (GSH), and increment of proinflammatory cytokine tumor necrosis factor-alpha (TNF-α) level, which were measured in bladder homogenates. PPZ pretreatment at three doses found to be effective in reducing the CP-induced elevation of MDA and TNF-α levels. The highest dose of PPZ (100 mg/kg) caused a significant increase in GSH level. CP induced severe HC with marked bladder edema and histological disturbances which were partially abolished by PPZ pretreatment. CONCLUSIONS: Our results indicate that PPZ pretreatment could attenuate CP-induced HC by interfering with oxidative stress and modulating proinflammatory cytokines.


Assuntos
Ciclofosfamida/efeitos adversos , Cistite/induzido quimicamente , Cistite/tratamento farmacológico , Imunossupressores/efeitos adversos , Pantoprazol/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico , Animais , Cistite/patologia , Modelos Animais de Doenças , Masculino , Camundongos , Pantoprazol/farmacologia , Inibidores da Bomba de Prótons/farmacologia
15.
J Infect Chemother ; 25(6): 413-422, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30905628

RESUMO

The Japanese Surveillance Committee conducted a second nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for acute uncomplicated cystitis (AUC) in premenopausal patients aged 16-40 years old at 31 hospitals throughout Japan from March 2015 to February 2016. In this study, the susceptibility of causative bacteria (Escherichia coli, Klebsiella pneumoniae, Staphylococcus saprophyticus) for various antimicrobial agents was investigated by isolation and culturing of organisms obtained from urine samples. In total, 324 strains were isolated from 361 patients, including E. coli (n = 220, 67.9%), S. saprophyticus (n = 36, 11.1%), and K. pneumoniae (n = 7, 2.2%). The minimum inhibitory concentrations (MICs) of 20 antibacterial agents for these strains were determined according to the Clinical and Laboratory Standards Institute (CLSI) manual. At least 93% of the E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, whereas 100% of the S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant and extended-spectrum ß-lactamase (ESBL)-producing E. coli strains were 6.4% (13/220) and 4.1% (9/220), respectively. The antimicrobial susceptibility of K. pneumoniae was retained during the surveillance period, while no multidrug-resistant strains were identified. In summary, antimicrobial susceptibility results of our second nationwide surveillance did not differ significantly from those of the first surveillance. Especially the numbers of fluoroquinolone-resistant and ESBL-producing E. coli strains were not increased in premenopausal patients with AUC in Japan.


Assuntos
Antibacterianos/farmacologia , Cistite/tratamento farmacológico , Farmacorresistência Bacteriana Múltipla , Escherichia coli/efeitos dos fármacos , Klebsiella pneumoniae/efeitos dos fármacos , Staphylococcus saprophyticus/efeitos dos fármacos , Adolescente , Adulto , Antibacterianos/uso terapêutico , Cistite/epidemiologia , Cistite/microbiologia , Monitoramento Epidemiológico , Escherichia coli/isolamento & purificação , Escherichia coli/metabolismo , Feminino , Humanos , Japão , Klebsiella pneumoniae/isolamento & purificação , Klebsiella pneumoniae/metabolismo , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Staphylococcus saprophyticus/isolamento & purificação , Staphylococcus saprophyticus/metabolismo , Adulto Jovem , beta-Lactamases/metabolismo
16.
J Infect Chemother ; 25(7): 498-502, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30852104

RESUMO

This study was performed to evaluate what percentage of urinary tract infections (UTIs) caused by extended spectrum ß-lactamase (ESBL)-producing strains recurs with ESBL-producing strains during follow up and to assess the risk factors for recurrence with ESBL-producing Escherichia coli strains on subsequent first recurrence episode. We enrolled female patients with UTIs caused by ESBL-producing E. coli between May 2012 and December 2015, who were longitudinally followed up for at least 24 months. Among the 206 patients with ESBL positive UTI, 180 completed the study. 60 (60/180, 33.3%) of patient with first episode of UTI caused by ESBL-producing E. coli experienced recurrent UTIs during follow up. Of 60 patients, 43 (43/60, 71.7%) recurred with ESBL-producing E. coli on the first UTI recurrence episode. On multivariate analysis, the time to recurrence and history of cephalosporin usage in the last 6 months were identified as risk factors for recurrence with ESBL-producing E. coli per se (odds ratio [OR] = 0.9, 95% confidence interval [CI] 0.8-1.0, p = 0.030 and OR = 27.0, 95% CI 2.4-299.8, p = 0.007, respectively). These findings show that high proportion of patient with UTI caused by ESBL-producing E. coli recurs with ESBL-producing E. coli on subsequent recurrence episode. While result of antibiotic susceptibility cannot be identified on the visit day empirical treatment should be referred to the antecedent antibiotic resistance profile in patients whose previous UTIs were due to ESBL-producing strains.


Assuntos
Cistite/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/fisiologia , Infecções Urinárias/microbiologia , Resistência beta-Lactâmica , Doença Aguda/terapia , Idoso , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Cefalosporinas/farmacologia , Cefalosporinas/uso terapêutico , Cistite/tratamento farmacológico , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Humanos , Estudos Longitudinais , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Recidiva , Infecções Urinárias/tratamento farmacológico
20.
Intern Med ; 58(10): 1495-1499, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30713304

RESUMO

A 64-year-old woman with no previous mental illness took a single 500 mg tablet of levofloxacin for cystitis. Two hours later, she developed psychosis with involuntary movement and severe hyperventilation with respiratory alkalosis. Cranial magnetic resonance imaging findings were unremarkable, and an electroencephalogram revealed no epileptiform discharge. Her symptoms improved on the third day after levofloxacin was discontinued. Levofloxacin-associated encephalopathy with psychotic features is a rare adverse event. Disturbance of gamma-aminobutyric acid-ergic (GABAergic) interneurons by levofloxacin may lead to hyperventilation via dysfunction of the brainstem respiratory network. Physicians should be aware of hyperventilation as an additional serious symptom of levofloxacin-associated encephalopathy in acute settings.


Assuntos
Anti-Infecciosos Urinários/efeitos adversos , Anti-Infecciosos Urinários/uso terapêutico , Encefalopatias/induzido quimicamente , Cistite/tratamento farmacológico , Hiperventilação/induzido quimicamente , Levofloxacino/efeitos adversos , Levofloxacino/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
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