ascorbic-acid and Bacteriuria

We conducted 202 trials in 161 male hospital patients to determine if prophylactic administration of ascorbic acid or antibacterials (trimethoprim-sulfamethoxazole, nalidixic acid, methenamine hippurate or nitrofurantoin macrocrystals) would prevent bacteriuria infections in spinal cord injury patients who had had at least 1 bout of bacteriuria. None of the drugs tested appeared to be statistically effective in the doses used in preventing bacteriuria in these patients. Moreover, sensitivities were lost to several drugs other than those used prophylactically. We conclude that use of prophylactic doses of ascorbic acid or antibacterials has not proved to be beneficial in spinal cord injury patients free of indwelling catheters.

Topics: Anti-Infective Agents, Urinary; Ascorbic Acid; Bacteriuria; Clinical Trials as Topic; Drug Combinations; Humans; Male; Methenamine; Nalidixic Acid; Nitrofurantoin; Spinal Cord Injuries; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Catheterization

Twenty-seven patients with indwelling urinary catheters and chronic bacteriuria were studied for methenamine efficacy. In a crossover fashion, each patient received methenamine mandelate granules 4 g/day alone, with ascorbic acid 4 g/day, and with ascorbic acid 4 g/day plus cranberry cocktail one 1/day. Proteus vulgaris, Pseudomonas aeruginosa, and E. coli were the common pathogens. Urinary acidifiers had no significant effect on mean urine pH, however, high urinary formaldehyde concentrations were associated with the use of ascorbic acid. Bacteriocidal formaldehyde levels were more frequently present in patients with acidic urine pH than those with alkaline pH. Although ascorbic acid increased formaldehyde levels, additional cranberry cocktail had no further effect. Despite higher formaldehyde levels, urine culture results were positive in most cases with or without urine acidification. Methenamine therapy may be of limited value in asymptomatic chronic bacteriuric patients with indwelling catheters.

Topics: Aged; Ascorbic Acid; Bacteriuria; Chronic Disease; Female; Formaldehyde; Fruit; Humans; Hydrogen-Ion Concentration; Male; Methenamine; Middle Aged; Urine

Topics: Adult; Ampicillin; Ascorbic Acid; Bacteriuria; Chronic Disease; Diuresis; Female; Humans; Kidney Failure, Chronic; Male; Prospective Studies; Pyelonephritis; Recurrence; Sulfadimethoxine; Urinary Tract Infections

Nitrite may be generated by bacteria in urine during urinary tract infections. Acidification of nitrite results in the formation of nitric oxide (NO) and other reactive nitrogen oxides, which are toxic to a variety of microorganisms. We have studied NO formation and bacterial growth in mildly acidified human urine containing nitrite and the reducing agent vitamin C. Urine collected from healthy subjects was incubated in closed syringes at different pH values with varying amounts of nitrite and/or ascorbic acid added. NO generation was measured in headspace gas using a chemiluminescence technique. A similar setup was also used to study the growth of three strains of bacteria in urine. Mildly acidified nitrite-containing urine generated large amounts of NO and this production was greatly potentiated by ascorbic acid. The growth of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus saprophyticus was markedly reduced by the addition of nitrite to acidified urine. This inhibition was enhanced by ascorbic acid. In conclusion, we show that the growth of three common urinary pathogens is markedly inhibited in mildly acidified urine when nitrite is present. The bacteriostatic effect of acidified nitrite is likely related to the release of NO and other toxic reactive nitrogen intermediates. These results may help to explain the well-known beneficial effects of urinary acidification with, e.g., vitamin C in treatment and prevention of urinary tract infection.

Topics: Adult; Ascorbic Acid; Bacteriuria; Escherichia coli; Humans; Hydrogen-Ion Concentration; Middle Aged; Nitric Oxide; Nitrites; Pseudomonas aeruginosa; Staphylococcus

To achieve effective suppression of bacteriuria in spinal cord injured (SCI) patients, methenamine mandelate and methenamine hippurate are commonly given with ascorbic acid. Since the effectiveness of ascorbic acid as a urinary acidifier has been challenged and as it also has been suggested that methenamine salts do not produce effective urine formaldehyde concentrations in patients with indwelling urethral catheters, we studied two groups of SCI patients to determine (1) the effect of ascorbic acid on urine pH and formaldehyde concentration when administered with methenamine salts; (2) the effect of an indwelling urethral catheter versus intermittent catheterization on formaldehyde concentration in the urine of SCI patients taking methenamine salts; and (3) the relative urine formaldehyde concentrations produced by treatment with methenamine mandelate and methenamine hippurate in SCI patients. Methenamine mandelate produced significantly higher urine formaldehyde concentrations than did methenamine hippurate, especially among patients with intermittent catheterization. Ascorbic acid produced a significant effect on urine pH but not on formaldehyde concentration.

Topics: Anti-Infective Agents, Urinary; Ascorbic Acid; Bacteriuria; Formaldehyde; Hippurates; Humans; Hydrogen-Ion Concentration; Mandelic Acids; Methenamine; Spinal Cord Injuries

This study involved 27 geriatric patients with asymptomatic chronic bacteriuria; all had indwelling Foley catheters. The treatment regimens (daily oral dosage) were: methenamine mandelate (MM) granules, 4 gm; MM, 4 gm, plus ascorbic acid, 4 gm; and MM, 4 gm, plus ascorbic acid, 4 gm, plus cranberry cocktail, 1 liter--administered according to a cross-over design. Proteus vulgaris, Pseudomonas aeruginosa and E. coli were the most common urinary organisms. Proteus organisms were more often found in alkaline than in acidic urines, but the type of pathogen had no influence on urinary pH. Urinary formaldehyde concentration [HCHO] was lower in patients with Proteus infection (17.7 micrograms/ml) than in those with Pseudomonas (21.9 micrograms/ml) or E. coli infection (21.8 micrograms/ml). However, for Proteus infection, [HCHO] was higher in patients receiving MM plus ascorbic acid than in those receiving MM alone. Addition of cranberry cocktail to ascorbic acid did not enhance urinary pH, [HCHO] or methenamine efficacy. Our data suggest that in Foley catheter patients with chronic asymptomatic bacteriuria secondary to Proteus, Pseudomonas or E. coli infection, the type of urinary pathogen or the urinary pH cannot be used to predict the efficacy of methenamine therapy either with or without urinary acidifying agents.

Topics: Aged; Ascorbic Acid; Bacteriuria; Escherichia coli Infections; Female; Formaldehyde; Humans; Hydrogen-Ion Concentration; Klebsiella Infections; Male; Methenamine; Proteus Infections; Proteus vulgaris; Providencia; Pseudomonas Infections

Ascorbic acid and hippuric acid (from cranberry juice) are commonly used to acidify the urine for the purpose of enhancing the degradation of therapeutic methenamine mandelate to urinary formaldehyde. A study was made of 27 nondiabetic geriatric patients with indwelling Foley catheters and chronic bacteriuria who were treated with methenamine mandelate (4 gm), ascorbic acid (4 gm), and cranberry cocktail (1 liter) daily. All of 972 urine samples showed formaldehyde in mean concentrations between 14 and 25 microgram/ml. No glucose was found when the urine was tested by the copper-reduction method. In vitro false positive reactions reported in the literature do not appear to be duplicated as an in vivo problem.

Topics: Aged; Ascorbic Acid; Bacteriuria; Copper; False Positive Reactions; Female; Formaldehyde; Glucose Tolerance Test; Glycosuria; Hippurates; Humans; Male; Methenamine

Topics: Albuminuria; Ascorbic Acid; Bacteriuria; Glycosuria; Hematuria; Humans; Indicators and Reagents; Methods; Reagent Strips; Urine

The reagent strip technique of quantitative urine culture was a satisfactory screening test for the detection of significant bacteriuria in dogs and cats. The reagent strip technique was found to be of almost equal sensitivity as the calibrated loop technique in identifying significant bacteriuria. Significant bacteriuria was detected in 38 of 148 urine samples evaluated by the calibrated loop technique. Of these 38 urine samples, significant bacteriuria was detected in 35 by the commercial test. False-negative results were obtained with reagent strips in 1 urine sample which had significant bacteriuria by the calibrated loop technique. The other 2 samples had bacterial counts of suspicious significance (10,000/ml of urine) by the reagent strip technique. False-positive results were obtained with the reagent strip technique in 3 urine samples; however, all 3 urine samples had bacterial counts (10,000/ml of urine) of suspicious significance when evaluated by the calibrated loop technique. The reagent strip technique was not satisfactory for the examination of patients with gross hematuria. The nitrite test portion of the commercial test did not detect significant bacteriuria in all samples and, therefore, was not suitable as a screening test for significant bacteriuria in dogs and cats. The nitrite test may have been inhibited by ascorbic acid, a metabolite which normally may exist in the urine of these animals.

Topics: Animals; Ascorbic Acid; Bacteriological Techniques; Bacteriuria; Cat Diseases; Cats; Culture Media; Dog Diseases; Dogs; Escherichia coli; Indicators and Reagents; Nitrites; Proteus; Reagent Strips

Topics: Adult; American Medical Association; Ascorbic Acid; Attitude of Health Personnel; Bacterial Infections; Bacteriuria; Child; Drug Combinations; Drug Therapy, Combination; Female; Humans; Infant, Newborn; Methenamine; Pregnancy; Pregnancy Complications, Infectious; Sulfamethoxazole; Trimethoprim; United States; United States Food and Drug Administration; Urinary Tract Infections

Topics: Ascorbic Acid; Bacteriuria; Humans; Male; Tetrazolium Salts

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Bacteriuria; Catalase; Female; Humans; Mass Screening; Methods; Microscopy; Middle Aged; Nitrates; Nitrites; Tetrazolium Salts

Topics: Ascorbic Acid; Bacteriuria; Escherichia coli; Humans; Hydrogen-Ion Concentration; In Vitro Techniques; Proteus; Pseudomonas aeruginosa