Presentation, Diagnosis, and Treatment of Urinary-Tract Infections in General Practice

Mond, N. C.; Percival, A.; Williams, John D.; Brumfitt, W.

doi:10.1016/s0140-6736(65)92020-9

Cited by 150 publications

(59 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Others (Gallagher, Montgomerie & North, 1965;Mond, Percival, Williams & Brumfitt, 1965;Steensberg et al 1969;Brooks & Maudar, 1972;Dove et at. 1972) have noted ratios of about 1-to-1 in smaller series where repeat examinations were excluded and in which there was likely to have been critical patient selection.…”

Section: Discussionmentioning

confidence: 99%

“…The position of Proteus spp. as the second most common organism isolated in urinary tract infections is usual (Loudon & Greenhalgh, 1962;Gallagher et al 1965;Mond et al 1965;McAllister et al 1971) except in the series where selection of patients by age and sex or by source has been such as to impose a different pattern (Steensberg et al 1969;Dove et al 1972). …”

Section: Discussionmentioning

confidence: 99%

“…for the age-Bacteriological examination of urine and sex-groups covered by the investigation quoted are combined. The pathogenic status of these organisms has been accepted by many for some time (Garrod et al 1954;Gallagher et al 1965;Mond et al 1965;Steensberg et al 1969), and they have been the subject of specific study (Pereira, 1962;Mitchell, 1965 Sandys (1960), provides a cheap non-inhibitory alternative which gives good colonial differentiation while suppressing the swarming of Proteus spp. A third possibility is that the MicrococcCus spp.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The bacteriological examination of urine: a computer-aided study

Meers

1974

J. Hyg.

View full text Add to dashboard Cite

SUMMARYFor 6 months details of every patient who had his or her urine sent to a laboratory for bacteriological examination and the result of such examination were entered on a computer-card. A total of 15,606 cards were completed with information in code recording the sex and age of a patient, the origin of the request, the presence or absence in the urine of an excess of protein or cells, the culture result and the name of any significant organism isolated together with its sensitivity to various antimicrobial drugs. This information was interrelated in a computer, and in some cases the resulting numerical details were expressed as rates so as to eliminate the effect of uneven sex and age distribution. In this waythe occurrence ofurinary tract infection and the type of infecting organism in persons of either sex at various ages was examined according to whether the patient was in hospital or general practice. The sensitivity pattern of each type of significant organism isolated was established according to its source. The association between patients of either sex and various ages who had, or did not have, bacteriologically evident infections and the presence in their urine of an inflammatory exudate was investigated. Finally, the capacity of each type of infecting organism to produce such an exudate was estimated.It was shown that hospital and general practice experience of urinary tract infections differed widely, with regard both to the age and sex distribution of those suffering from it, and to the causative organisms concerned and their sensitivities to antimicrobial drugs. It is suggested that these differences were so great that conclusions drawn from any study of this subject conducted in one of the two areas cannot be applied to the other, and that those derived from a mixture of the two will vary according to the relative sizes of each of the components.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The bacteriological examination of urine: a computer-aided study

Meers

1974

J. Hyg.

View full text Add to dashboard Cite

show abstract

“…This conclusion is supported by several studies in the literature. For example, early studies of women with acute dysuria and frequent urination observed that approximately one-half of these patients did not have 2105 bacteria per ml or urine (7,11,24). Sterile urine samples were obtained from 17 to 32% of these patients, leaving approximately onefourth of acutely symptomatic women with positive cultures with colony counts of <105 organisms per ml.…”

Section: Discussionmentioning

confidence: 99%

Randomized clinical trial of rifampin-trimethoprim and sulfamethoxazole-trimethoprim in the treatment of localized urinary tract infections

Stein

Gurwith

1988

Antimicrob Agents Chemother

View full text Add to dashboard Cite

To investigate whether 10 days of rifampin-trimethoprim (RIF-TMP) or 6 weeks of sulfamethoxazoletrimethoprim (SMX-TMP) would decrease the relapse rate in patients with acute uncomplicated upper urinary tract infections in comparison with 10 days of SMX-TMP, we randomized 189 patients to receive RIF-TMP or SMX-TMP in a ratio of 1:2. After the site of infection was established by the antibody-coated bacterium (ACB) test, patients with upper-tract infections who received SMX-TMP were again randomized and received either a total of 6 weeks or 10 days of therapy. All patients who received RIF-TMP were treated for 10 days. Clinical and microbiological evaluations were repeated at 2 and 6 weeks posttreatment. Eighty-five patients (54 ACB positive) received 10 days of RIF-TMP, 71 patients (45 ACB positive) received 10 days of SMX-TMP, and 18 patients (18 ACB positive) received 6 weeks of SMX-TMP. The overall recurrence rates in patients who received 10 days of therapy were 32% for RIF-TMP and 23% for SMX-TMP (P = 0.13). There were 12 (14%) relapses in the RIF-TMP group compared with 2 (3%) relapses in the SMX-TMP group (P = 0.01). In patients with upper-tract infections, the relapse rates were not statistically significantly different (P 0.13). There were two (11%) recurrences (one relapse and one reinfection) in the 6-week treatment group. This 6% relapse rate was not different from the 4% relapse rate observed in patients with upper-tract infections who received 10 days of SMX-TMP. The number of patients who discontinued treatment because. of an adverse effect in the 6-week SMX-TMP treatment group was significantly greater than those in the 10-day SMX-TMP treatment group (P = 0.003) and the RIF-TMP treatment group (P = 0.05). Ten days of SMX-TMP was as effective as 6 weeks of SMX-TMP or 10 days of RIF-TMP in the treatment of uncomplicated upper urinary tract infections and caused the fewest untoward effects.Rifampin has antimicrobial activity against most urinary pathogens (10, 15, 20) and demonstrates good tissue and intracellular penetration. Even though the main excretory route for rifampin is through the bile, concentrations in urine well above the MIC for most urinary pathogens are found after single doses (18). The drawback to using rifampin alone to treat urinary tract infections (UTI) is rapid emergence of rifampin-resistant strains (27). Trimethoprim is particularly active against aerobic gram-negative bacteria, and the combination rifampin-trimethoprim (RIF-TMP) is synergistic against most urinary pathogens (10, 16, 20). This combination protects against emergence of resistance seen in bacterial populations exposed to either drug alone (3,14,15). In addition, the pattern of absorption and excretion of rifampin and trimethoprim given alone does not differ significantly from that when they are given concurrently (1, 18).The combination RIF-TMP has been reported to be effective in the treatment of acute (21, 27) and chronic (2, 6) UTI and is a potential alternative to sulfamethoxazole plus trimethoprim (SMX-TMP...

show abstract

“…These methods were designed to rapidly screen thousands of asymptomatic individuals and in a small percentage of patients may not be appropriate. The laboratory can confirm the diagnosis of UTI in many symptomatic cases, but significant bacteriuria is found in only half of the patients with urinary symptomatology (Gallagher et al, 1965;Mond et al, 1965). In many infected patients with renal calculi or other upper tract disease, bacterial counts may be below 105 per ml.…”

Section: The Concept Ofsignificant Bacteriuriamentioning

confidence: 99%