The Localization and Treatment of Urinary Tract Infections: The Role of Bactericidal Urine Levels as Opposed to Serum Levels

Suprapubic Bladder Aspiration in Diagnosis of Urinary Tract Infection

“…In the series of 2,500 aspirations without complication reported by Stamey et al (1965), one-third had a bacterial count of less than 100,000 organisms per ml. The same workers showed that hydration reduced the bacterial counts to the 10,000-100,000 organisms per ml.…”

“…The technique has now been shown to be quite safe in premature infants, neonates, children, and adults, including antenatal patients (Beard, McCoy, Newton, and Clayton, 1965 ;Nelson and Peters, 1965;Pryles, 1965;Stamey, Govan, and Palmer, 1965;Newman, O'Neill, and Parker, 1967;McFadyen and Eykyn, 1968).…”

An infectious disease and pharmacokinetic perspective on oral antibiotic treatment of uncomplicated urinary tract infections due to multidrug-resistant Gram-negative uropathogens: the importance of urinary antibiotic concentrations and urinary pH

“…Stamey was the first to advance the concept of urinary (vs. serum) antibiotic spectrum [1]. Clinically, it is important to appreciate that in vitro antibiotic susceptibility testing is based on achievable serum, not urinary, antibiotic concentrations.…”

“…Urinary antibiotic susceptibilities often differ considerably from serum susceptibilities [2][3][4][5][6]. Stamey reported that oral penicillin, due to high achievable urinary concentrations, easily eradicated Escherichia coli in urine, even though the E. coli was "resistant" by serum-derived susceptibilities [1,4]. Stamey and others also showed that oral tetracycline, e.g., doxycycline, was effective in eradicating "tetracycline-resistant" Pseudomonas aeruginosa from urine.…”

Urinary tract infection.

“…Careful specimen collection is essential to the correct interpretation of results. Entry into (Gower et al, 1975;Stamey et al, 1965) and of infrequent doses of the more active agents (Cattell et al, 1968 It is also important that the susceptibility to the antibiotic used of bacteria causing infection should be established before and, in the case of recurrent infection, after treatment. In this way failure due to primary resistance or to resistance emerging during therapy can be assessed.…”