scholarly journals A short course of antimicrobial therapy for asymptomatic bacteriuria is safe and effective before urologic procedures

2021 ◽  
Vol 15 (05) ◽  
pp. 742-746
Author(s):  
Murat Kutlu ◽  
Merve Arslan ◽  
Yusuf Ozlulerden ◽  
Kevser Ozdemir ◽  
Selda Sayin-Kutlu ◽  
...  
Keyword(s):  
Single Dose ◽  
Antimicrobial Therapy ◽  
Urinary Catheter ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment ◽  
Sensitivity Testing ◽  
Post Procedure ◽  
Short Course ◽  
Urological Procedures ◽  
The Mean

Introduction: In the presence of asymptomatic bacteriuria (ASB) before the urological procedure, the duration of antimicrobial treatment is controversial. This study aims to evaluate whether a short course of antimicrobial therapy is safe and effective in cases with ASB before urological procedures. Methodology: We retrospectively reviewed adult patients who had ASB before undergoing several urological procedures between 2011 and 2019. The patients received a single dose of an appropriate parenteral antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the urological procedure. If a urinary catheter was placed post-procedure, a second dose was given. Results: A total of 293 patients who had ASB before undergoing several urological procedures were included in the study. The total number of procedures was 328. Female/male ratio was 92 (31.4%)/201 (68.6%). The mean age was 63.7 ± 14.9 years. The most common isolated microorganisms were Escherichia coli (155 [47%]), Klebsiella pneumoniae (38 [11.6%]), and Pseudomonas aeruginosa (28 [8.5%]). The most common antimicrobial used was ertapenem. A second dose antimicrobial was given for 290 procedures due to a urinary catheter after a urological procedure. The mean hospitalization time was 3.97 ± 3.42 days. None of the patients developed infectious complications. Conclusions: This study has demonstrated that a single dose of parenteral antimicrobial drug administered 30-60 minutes before the urologic procedures and a second dose in the presence of a post-procedure catheter, was adequate to prevent post-procedure septicemia and urinary tract infection.

scholarly journals Is short course of antimicrobial therapy for asymptomatic bacteriuria before urologic surgical procedures sufficient?

2011 ◽  
Vol 6 (02) ◽  
pp. 143-147 ◽  
Author(s):  
Selda Sayin Kutlu ◽  
Zafer Aybek ◽  
Koray Tekin ◽  
Demet Okke ◽  
Serife Akalin ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Antimicrobial Therapy ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment ◽  
Sensitivity Testing ◽  
Urologic Surgical Procedures ◽  
Short Course ◽  
Group A ◽  
Urological Procedures ◽  
Group B

Introduction: Duration of treatment of asymptomatic bacteriuria for patients undergoing urologic surgical procedures is undetermined. We compared the efficacy of long- versus short-course antimicrobial treatment in patients with asymptomatic bacteriuria undergoing urologic surgical procedures. Methodology: Patients were divided into two groups according to duration of antimicrobial treatment. Group A patients received a single dose of an appropriate antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the surgical procedure. If a urinary catheter was placed postoperatively, a second dose was given following the recommended dose interval. Group B patients received antimicrobial treatment prior to surgery at least until patient urine became sterile. All patients were monitored for signs and symptoms of septicemia following surgical procedures. Results: None of the patients enrolled in the study developed infectious complications such as sepsis or upper urinary tract infection. In group A, 31 patients were treated with antimicrobials before 39 urological procedures. In group B, the mean treatment time for 28 patients before 30 urological procedures was 8.03 ± 3.86 days. There were also significant differences in length of stay and the cost of antimicrobial therapy between the groups (P < 0.0001). Isolation of an increased number of resistant microorganisms was associated with long course therapy in group B. Conclusions: Short course therapy protocol may be a practical, simple approach for antibiotic use; it decreases hospital stays, eliminates delayed procedure times, lowers the economic cost of antimicrobials and lessens the chance of superinfection with and spread of antimicrobial resistant microorganisms.

scholarly journals Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

2015 ◽  
Vol 53 (9) ◽  
pp. 2895-2899 ◽  
Author(s):  
Hazel C. Dobinson ◽  
Trevor P. Anderson ◽  
Stephen T. Chambers ◽  
Matthew P. Doogue ◽  
Lois Seaward ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Breast Tissue ◽  
Antimicrobial Agents ◽  
Treatment Options ◽  
Antimicrobial Treatment ◽  
Granulomatous Mastitis ◽  
Sensitivity Testing ◽  
Treatment Protocols ◽  
Content Type ◽  
16S Rna

Corynebacteriumspecies are increasingly recognized as important pathogens in granulomatous mastitis. Currently, there are no published treatment protocols forCorynebacteriumbreast infections. This study describes antimicrobial treatment options in the context of other management strategies used for granulomatous mastitis.Corynebacteriumspp. isolated from breast tissue and aspirate samples stored from 2002 to 2013 were identified and determined to the species level using matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS), 16S RNA sequencing, andrpoBgene targets. The MICs for 12 antimicrobials were performed using Etest for each isolate. Correlations of these with antimicrobial characteristics, choice of antimicrobial, and disease outcome were evaluated.Corynebacteriumspp. from breast tissue and aspirate samples were confirmed in 17 isolates from 16 patients. Based on EUCAST breakpoints,Corynebacterium kroppenstedtiiisolates (n= 11) were susceptible to seven antibiotic classes but resistant to β-lactam antibiotics.Corynebacterium tuberculostearicumisolates (n= 4) were multidrug resistant. Two nonlipophilic species were isolated,Corynebacterium glucuronolyticumandCorynebacterium freneyi, both of which have various susceptibilities to antimicrobial agents. Short-course antimicrobial therapy was common (median, 6 courses per subject; range, 1 to 9 courses). Patients withC. kroppenstedtiipresented with a hot painful breast mass and underwent multiple surgical procedures (median, 4 procedures; range, 2 to 6 procedures). The management ofCorynebacteriumbreast infections requires a multidisciplinary approach and includes culture and appropriate sensitivity testing to guide antimicrobial therapy. Established infections have a poor outcome, possibly because adequate concentrations of some drugs will be difficult to achieve in lipophilic granulomata. Lipophilic antimicrobial therapy may offer a therapeutic advantage. The role of immunotherapy has not been defined.

Short-Course and Single-Dose Antimicrobial Therapy for Chancroid in Kenya: Studies with Rifampin Alone and in Combination with Trimethoprim

1983 ◽  
Vol 5 (Supplement_3) ◽  
pp. S565-S572 ◽  
Author(s):  
Frank A. Plummer ◽  
Nsanze Herbert ◽  
Lourdes J. D'Costa ◽  
A. B. Ndugga Maggwa ◽  
Yves Girouard ◽  
...  
Keyword(s):  
Single Dose ◽  
Antimicrobial Therapy ◽  
Short Course

scholarly journals 1116. Comparison of Short-Course vs. Prolonged-Course Antimicrobial Therapy in the Management of Intra-Abdominal Infections

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S334-S334
Author(s):  
Mina Phlamon ◽  
Sarah Petite ◽  
Kelli Cole
Keyword(s):  
Logistic Regression ◽  
Antimicrobial Therapy ◽  
Clinical Cure ◽  
Antimicrobial Treatment ◽  
Multivariable Logistic Regression ◽  
Short Course ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Secondary Outcomes ◽  
Abdominal Infections

Abstract Background When managing complicated intra-abdominal infections (IAIs), the current Infectious Diseases Society of America (IDSA) guidelines recommend an antimicrobial treatment duration of 4–7 days. Although recent evidence supports this shorter course of therapy, antimicrobials are still often administered for 10–14 days due to concern for subsequent complications. The purpose of this study was to compare clinical outcomes of short-course (SC) vs. prolonged-course (PC) antimicrobial therapy in the management of IAI at our institution. Methods IRB-approved, single-center, retrospective cohort including all patients at the University of Toledo Medical Center who were admitted between January 1, 2012–June 30, 2017 with an IAI, received antimicrobials for ≥48 hours, and had at least one sign of IAI. Patients with concomitant infections at sites other than the abdomen, primary peritonitis or pancreatitis, immunocompromising conditions, or bacteremia were excluded. Primary outcome of clinical cure was compared between SC (≤7 days of antimicrobial treatment) and PC (&gt;7 days) groups. Secondary outcomes included hospital length of stay (LOS), ICU LOS, 28-day all-cause mortality, and 30-day readmission. Multivariable logistic regression was performed to assess for factors associated with clinical cure. Results One hundred seventy-five patients were included, 73 SC and 102 PC. Baseline characteristics were similar between groups. Rate of clinical cure for SC vs. PC was 74.0% vs. 67.6% (P = 0.367). Secondary outcomes including hospital LOS (5.5 days vs. 5.8 days, P = 0.372), ICU LOS (3.0 days vs. 5.0 days, P = 0.117), 28-day all-cause mortality (4.1% vs. 2.0%, P = 0.651), and 30-day readmission (19.2% vs. 20.6%, P = 0.818) were also not significantly different. After multivariable logistic regression, the only variable independently associated with clinical cure was diverticulitis (adjusted odds ratio 0.337, 95% CI 0.133 – 0.853). Conclusion In patients with IAI, there was no significant difference observed in rates of clinical cure between SC and PC antimicrobial therapy. These results further support the IDSA recommendations for a shorter duration of therapy for patients with IAI. Disclosures All authors: No reported disclosures.

scholarly journals Antibiotic Sensitivity Pattern of Uropathogens in Diabetic Women with Asymptomatic Bacteriuria

2020 ◽  
Vol 9 (2) ◽  
pp. 40-144
Author(s):  
Nadeem Islam Sheikh ◽  
Ambreen Zahoor ◽  
Mehreen Baber ◽  
Zaidan Idrees Choudhary
Keyword(s):  
Asymptomatic Bacteriuria ◽  
Antibiotic Sensitivity ◽  
Sensitivity Testing ◽  
E Coli ◽  
Common Organism ◽  
Sensitivity Pattern ◽  
The Mean ◽  
Tract Infections ◽  
Type 2 Diabetic

Background: More than 150 million people around the globe are diagnosed with urinary tract infections every year. Failure to treat these infections with proper antibiotics can lead to serious complications. The objective of this study was to investigate antibiotic sensitivity and resistance pattern of urinary isolates in type-2 diabetic women with asymptomatic bacteriuria. Material and Methods: This cross-sectional descriptive study was conducted at the HBS General Hospital, Islamabad, from March 2017 to August 2019. A total of 270 females with the diagnosis of type-2 diabetes mellitus were included in the study. Uropathogens were isolated from urine samples and antibiotic sensitivity testing was conducted. Demographic and clinical information was recorded on a pre-designed proforma. The data was analyzed using SPSS version 20. Results: The mean age of the study sample was 50 years (SD ± 5.5) while the mean HbA1c levels were 8.98 g/dL (SD ± 0.8 g/dl). Uropathogens were found in the urine cultures of 106 (39.3%) patients. Extended Spectrum Beta-Lactamase producing (ESBL) Escherichia coli (E. coli) was the most common organism (n=46, 43.4%) which was sensitive to tazobactam, tazocin and co-trimoxazole. Nitrofurantoin was the most effective antibiotic with 62.5% isolates sensitive to it. All of the pathogens were resistant to ciprofloxacin. Conclusions: Asymptomatic bacteriuria is common in type-2 diabetic women with ESBL E. Coli being the most common organism isolated from urine cultures. There is a significant resistance to antibiotics among the uropathogens isolated from these patients.

Bacteremia and Mortality with Urinary Catheter–Associated Bacteriuria

2013 ◽  
Vol 34 (11) ◽  
pp. 1153-1159 ◽  
Author(s):  
Quratulain F. Kizilbash ◽  
Nancy J. Petersen ◽  
Guoqing J. Chen ◽  
Aanand D. Naik ◽  
Barbara W. Trautner
Keyword(s):  
Antimicrobial Agents ◽  
Urine Culture ◽  
Urinary Catheter ◽  
Tertiary Care ◽  
Asymptomatic Bacteriuria ◽  
Care Facility ◽  
Antimicrobial Treatment ◽  
Positive Urine Culture ◽  
Tertiary Care Facility ◽  
Positive Urine

Objective.Although catheter-associated urinary tract infection (CAUTI) and catheter-associated asymptomatic bacteriuria (CAABU) are clinically distinct conditions, most literature describing the risks of bacteriuria does not distinguish between them. We studied the relationship between catheter-associated bacteriuria and bacteremia from a urinary source in CAUTI relative to that in CAABU. Second, we investigated whether the presence or absence of urinary symptoms in catheterized patients with bacteriuria was associated with bacteremia from any source or mortality. Finally, we explored the effect of antimicrobial treatment of bacteriuria on subsequent bacteremia from any source and mortality.Design.We performed a retrospective cohort study with 30 days of follow-up after an initial positive urine culture. CAUTI and CAABU were defined by Infectious Diseases Society of America guidelines.Setting. A large tertiary care facility.Patients.All inpatients with a urinary catheter (external or indwelling) and a positive urine culture between October 2010 and June 2011.Results.We captured 444 episodes of catheter-associated bacteriuria in 308 patients; 128 (41.6%) patients had CAUTI, and 180 (58.4%) had CAABU. Three episodes of bacteriuria were followed by bacteremia from a urinary source (0.7%). CAUTI, rather than CAABU, was associated with bacteremia from any source, but neither CAUTI nor CAABU predicted subsequent mortality. Use of antimicrobial agents to treat bacteriuria was not associated with either bacteremia from any source or mortality.Conclusions.Bacteremia from a urinary source was infrequent, and there was no evidence of an association of mortality with symptomatic versus asymptomatic bacteriuria in this population. Antibiotic treatment of bacteriuria did not affect outcomes.

scholarly journals 1679. Evaluation of the Treatment of Urinalyses and Urine Cultures in Multiple Sclerosis Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S824-S825
Author(s):  
Nicole C Griffith ◽  
Brandon Hill ◽  
S Ross Tingen ◽  
J Cameron Crowe
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract ◽  
Antimicrobial Therapy ◽  
Asymptomatic Bacteriuria ◽  
Empiric Therapy ◽  
Antimicrobial Treatment ◽  
Lower Urinary Tract Dysfunction ◽  
Treatment Practices ◽  
Secondary Endpoints ◽  
Multiple Sclerosis Patients

Abstract Background Patients with Multiple Sclerosis (MS) experience lower urinary tract dysfunction (LUTD) that in some cases, may necessitate catheterization. Discerning asymptomatic bacteriuria (ASB) from urinary tract infection (UTI) in MS patients is complicated by LUTD, leading to potentially inappropriate antimicrobial use. The purpose of this study was to evaluate the antimicrobial treatment practices of positive urine cultures in patients with MS. Methods: A single-center, retrospective study. Positive cultures in patients with diagnosed MS (ICD10: G35) were included. The primary outcome was the proportion of patients that were appropriately treated with or without antimicrobial therapy. Secondary endpoints included antimicrobial selection and urinalysis obtainment and positivity. Results 236 cultures from 139 patients were evaluated. Frequency, nocturia, dysuria, and foul-smelling urine were reported by patients in 54 (23%), 10 (4%), 25 (11%), and 14 (6%) of cases, respectively. Treatment was inappropriate in 81/201 (40%) of treated cultures. The agent selected was considered too broad in 35/201 (17%) instances. Of those, fluoroquinolones were the agents utilized in 33/35 (94%) cases. A urinalysis was sent in 200 (85%) cases, with 197/200 (99%) positive for at least one of four pre-defined positivity criteria. Conclusion Urinalyses and urine cultures are obtained frequently in patients with MS, often independent of patient symptomatology. Multiple sclerosis patients may be treated for ASB at higher rates than the general population, and traditional urinary symptoms may not be appropriate indicators of infection. Empiric therapy for UTI is frequently utilized in this population, often resulting in too broad of antimicrobial therapy. Disclosures All Authors: No reported disclosures

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