ascorbic-acid and Urinary-Tract-Infections

Urinary tract infections (UTIs) are common in pregnancy and account for the highest proportion of primary care antibiotic prescriptions issued to pregnant women in the UK. It is well known that antibiotic use is associated with increased antimicrobial resistance and therefore measures to minimise antibiotic use for UTI prevention have been studied. The efficacy and safety of these measures in pregnancy have not been addressed and therefore the aim of this study was to systematically review the literature to identify and evaluate potential measures to prevent UTIs in pregnant women.. Ten databases (EMBASE, AMED, BNI, CINAHL, Medline, PubMed, PsycINFO, Cochrane Trials, Scopus and Science Direct) were systematically searched in July 2017 for studies reporting non-antibiotic measures to prevent UTIs in pregnancy. The terms ("urinary tract infection" or UTI or bacteriuria or cystitis) AND (prevention) AND (pregnan*) were used. The quality of the publications was appraised using the Critical Appraisal Skills Programme (CASP) checklists for cohort study, case-control study and randomised controlled trial. The results were synthesised using a textual narrative approach.. Search results yielded 3276 publications and after reviewing titles and removing duplicates, 57 full text articles were assessed for eligibility and eight were included in the review. Five different approaches (hygiene measures, cranberry juice, immunisation, ascorbic acid and Canephron® N) have been identified, all of which are reported to be safe in pregnancy.. The quality of the evidence varied considerably and only hygiene measures were supported by evidence to be recommended in practice. Future work needs to concentrate on strengthening the evidence base through improved design and reporting of studies with a focus on immunisation, ascorbic acid and Canephron® N.

Topics: Ascorbic Acid; Dietary Supplements; Female; Fruit and Vegetable Juices; Humans; Hygiene; Immunization; Phytotherapy; Plant Extracts; Pregnancy; Pregnancy Complications, Infectious; Prenatal Care; Urinary Tract Infections; Vaccinium macrocarpon

Recurrent urinary tract infections (UTIs) are common, especially in women. Low-dose daily or postcoital antimicrobial prophylaxis is effective for prevention of recurrent UTIs and women can self-diagnose and self-treat a new UTI with antibiotics. The increasing resistance rates of Escherichia coli to antimicrobial agents has, however, stimulated interest in nonantibiotic methods for the prevention of UTIs. This article reviews the literature on efficacy of different forms of nonantibiotic prophylaxis. Future studies with lactobacilli strains (oral and vaginal) and the oral immunostimulant OM-89 are warranted.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Ascorbic Acid; Bacterial Vaccines; Estrogens; Female; Humans; Lactobacillus; Recurrence; Self Care; Urinary Tract Infections

Urinary tract infections (UTI) remain one of the most prevalent and frustrating morbidities for neurogenic bladder patients, and death attributed to urosepsis in the spinal cord injury (SCI) patient is higher when compared to the general population. Risk factors include urinary stasis, high bladder pressures, bladder stones, and catheter use. While classic symptoms of UTI include dysuria, increased frequency and urgency, neurogenic bladder patients present differently with increased spasticity, autonomic dysreflexia, urinary incontinence, and vague pains. Multiple modalities have been assessed for prevention including catheter type, oral supplements, bladder irrigation, detrusor injections and prophylactic antimicrobials. Of these, bladder inoculation with E. coli HU2117, irrigation with iAluRil(®), detrusor injections, and weekly prophylaxis with alternating antibiotics appear to have a positive reduction in UTI but require further study. Ultimately, treatment for symptomatic UTI should account for the varied flora and possible antibiotic resistances including relying on urine cultures to guide antibiotic therapy.

Topics: Administration, Intravesical; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Antibiotic Prophylaxis; Antioxidants; Ascorbic Acid; Botulinum Toxins, Type A; Catheter-Related Infections; Escherichia coli; Escherichia coli Infections; Humans; Immunotherapy, Active; Mannose; Methenamine; Multiple Sclerosis; Neuromuscular Agents; Proanthocyanidins; Probiotics; Recurrence; Spinal Cord Injuries; Urinary Bladder, Neurogenic; Urinary Catheterization; Urinary Catheters; Urinary Tract Infections

Malacoplakia is a rare inflammatory disorder seen most often in the urinary tract, where it is highly associated with coliform infection. Although first recognized by pathologists in 1902, it has received little attention from the infectious disease community. While there remains much uncertainty regarding the specific cause of malacoplakia, it appears to be associated with a defect in intracellular killing of ingested microorganisms by macrophages. We report a case of bilateral renal parenchymal malacoplakia that presented as fever of unknown origin, and we review 33 previously identified cases. Renal malacoplakia has traditionally been associated with high morbidity and mortality. More recently, treatment with antimicrobial agents such as trimethoprim or ciprofloxacin has yielded a better outcome than had been documented with other therapy. Malacoplakia should be considered in the evaluation of fever of unknown origin or of relapsing or refractory urinary tract infection. Therapy with antimicrobial agents capable of intracellular penetration is recommended.

Topics: Anti-Infective Agents; Ascorbic Acid; Bethanechol; Bethanechol Compounds; Female; Fever of Unknown Origin; Humans; Kidney Diseases; Malacoplakia; Middle Aged; Urinary Tract Infections

Present knowledge concerning carcinogenesis and the natural history of urothelial tumours precludes firm conclusions relative to nonindustrial prophylaxis. However, a number of measures are consistent with current data and may be instituted for those patients with a demonstrated propensity to urothelial tumours. Their acceptability is based on the lack of associated toxicity for the patient. These measures include the elimination of significant infection, cigarettes, artificial sweeteners, analgesic abuse and coffee, the administration of vitamins C and B(6), and in selected cases, the use of thiotepa. It is emphasized that the merit of these steps in altering the natural history of urothelial tumours is uncertain.

Topics: Analgesics; Ascorbic Acid; Coffee; Female; Humans; Male; Papilloma; Pyridoxine; Sex Factors; Smoking; Sweetening Agents; Thiotepa; Urethral Stricture; Urinary Bladder Neoplasms; Urinary Tract Infections; Urination Disorders

Topics: Anti-Bacterial Agents; Ascorbic Acid; Child; Child, Preschool; Endoscopy; Female; Humans; Infant; Kidney Function Tests; Male; Methenamine; Methionine; Pyelonephritis; Radiography; Ureter; Ureteral Obstruction; Ureterocele; Urinary Tract Infections; Vesico-Ureteral Reflux

To determine the safety, tolerability, maximal tolerated dose, and efficacy of a concentrated cranberry liquid blend, UTI-STAT with Proantinox, in female patients with a history of recurrent urinary tract infections (rUTIs).. The study agent was administered orally at 15, 30, 45, 60, and 75 mL daily for 12 weeks to women with a history of 2.78 ± 0.73 rUTIs <6 months. Blood and urine samples were collected at baseline and weeks 4 and 12. The women took daily doses of the agent. The primary endpoints were the safety, tolerability, and maximal tolerated dose. The secondary endpoints were the efficacy with regard to rUTI and quality-of-life (QOL) symptoms.. A total of 28 subjects were included in the study. Of these 28 women, the data from 23 were analyzable. The average age was 46.5 ± 12.8 years. The maximal tolerated dose of UTI-STAT was 75 mL/d, and the recommended dose was set at 60 mL/d. The secondary endpoints demonstrated that only 2 (9.1%) of 23 reported a rUTI, a markedly better rate than the historical data. At 12 weeks, the reduction in worry about rUTIs and increased QOL with regard to the physical functioning domain and role limitations from physical health domain, as measured by the Medical Outcomes Study short-form 36-item questionnaire, were significant (P = .0097). A lower American Urological Association Symptom Index indicating greater QOL was also significant (P = .045).. The novel concentrated cranberry liquid blend showed a good safety profile and tolerability in both pre- and postmenopausal women with history of rUTIs. The secondary endpoints demonstrated its effectiveness in reducing the incidence of rUTI and increasing QOL. Given this evidence, supplementation might be beneficial in the prevention of rUTIs in this population.

Topics: Adult; Aged; Antioxidants; Ascorbic Acid; Bromelains; Dose-Response Relationship, Drug; Female; Gastrointestinal Diseases; Humans; Mannose; Maximum Tolerated Dose; Menopause; Middle Aged; Oligosaccharides; Phytotherapy; Plant Extracts; Prospective Studies; Quality of Life; Secondary Prevention; Urinary Tract Infections; Vaccinium macrocarpon; Young Adult

To evaluate the role a daily intake of 100 mg of ascorbic acid plays in urinary infection prophylaxis during pregnancy.. A single-blind clinical trial was carried out on pregnant women randomly assigned to the following treatment groups - Group A: oral treatment with ferrous sulphate (200 mg per day), folic acid (5 mg per day) and ascorbic acid (100 mg per day) for 3 months, and Group B: oral treatment with ferrous sulphate (200 mg per day) and folic acid (5 mg per day) for 3 months. All patients were clinically evaluated, and a urine culture was carried out each month for a period of 3 months. The chi(2) and odds ratio were used to compare effects with and without ascorbic acid, and statistical significance was considered at p<0.05.. Global frequency of urinary infections was 25%. The presence of urinary infections in Group A (12.7%) was significantly lower than in Group B (29.1%), (p=0.03, OR =0.35, CI 95% =0.13-0.91).. Daily intake of 100 mg of ascorbic acid played an important role in the reduction of urinary infections, improving the health level of the gestating women. We recommend additional vitamin C intake for pregnant women in populations which have a high incidence of bacteriuria and urinary infections.

Topics: Adolescent; Adult; Ascorbic Acid; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Single-Blind Method; Urinary Tract Infections; Urine; Vitamins

The effect of ascorbic acid on urine pH was studied in spinal cord injury patients. Their urine was not colonized by urease positive microorganisms. The study was designed to compare the baseline urine pH value and the urine pH value after the administration of placebo or ascorbic acid 500 mg/6 h. The diet and medical treatment were not controlled. A significant decrease in urine pH value was not obtained. There was no clinical benefit from the use of ascorbic acid.

Topics: Adolescent; Adult; Ascorbic Acid; Diet; Female; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Single-Blind Method; Spinal Cord Injuries; Urease; Urinary Bladder, Neurogenic; Urinary Tract Infections

The ability of ascorbic acid to lower urinary pH in patients with spinal cord injury and neurogenic bladder was studied. Ascorbic acid (1 g four times daily) or placebo was administered for five days in a double-blind, crossover study to 20 patients with spinal cord injury and neurogenic bladder. Urine pH was measured for two days before and during administration of placebo or ascorbic acid. The mean decrease in urinary pH with ascorbic acid was 0.58, but this reduction was not statistically or clinically significant. Only 7 of 20 patients showed a mean urine pH of 5.5 or less (acidic) during treatment with ascorbic acid. The study suggests that an ascorbic acid dosage of 1 g four times daily should not be used to maintain an acidic urinary pH for control of urinary tract infections in patients with spinal cord injuries.

Topics: Adolescent; Adult; Ascorbic Acid; Female; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Spinal Cord Injuries; Urinary Bladder, Neurogenic; Urinary Catheterization; Urinary Tract Infections; Urine

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Bacteria; Bacteriological Techniques; Child; Child, Preschool; Clinical Trials as Topic; Drug Combinations; Drug Therapy, Combination; Female; Humans; Male; Methenamine; Middle Aged; Recurrence; Sulfamethoxazole; Trimethoprim; Urethra; Urinary Tract Infections

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

Resistance to antibiotics has increased steadily over time, thus there is a pressing need for safer alternatives to antibiotics. Current study aims to evaluate the influence of vitamin C as an antibacterial and anti-biofilm agent against uropathogenic E. coli (UPEC) strains. The expression of beta-lactamases and biofilm encoding genes among E. coli isolates before and after treating the isolates with sub MIC of vitamin C was analyzed by Real-time PCR. The in vivo assessment of the antibacterial and anti-biofilm effects of vitamin C against uropathogenic E. coli strains was done using a urinary tract infection (UTI) rat model.. The effective concentration of vitamin C that could inhibit the growth of most study isolates (70%) was 1.25 mg/ml. Vitamin C showed a synergistic effect with most of the studied antibiotics; no antagonistic effect was detected at all. Vitamin C showed an excellent anti-biofilm effect against studied isolates, where 43 biofilm-producing isolates were converted to non-biofilm at a concentration of 0.312 mg/ml. The expression levels of most studied genes were down-regulated after treatment of E. coli isolates with vitamin C. In vivo assessment of vitamin C in treating UTIs showed that vitamin C has a rapid curative effect as the comparable antibiotic. Administration of both vitamin C and nitrofurantoin at a lower dose for treatment of UTI in rats had a better effect.. Vitamin C as an antibacterial and anti-biofilm agent either alone or in combination with antibiotics could markedly improve UTI in experimental rats.

Topics: Animals; Anti-Bacterial Agents; Ascorbic Acid; Escherichia coli Infections; Nitrofurantoin; Rats; Urinary Tract Infections; Uropathogenic Escherichia coli; Vitamins

Topics: Aminoglycosides; Anti-Bacterial Agents; Ascorbic Acid; Biofilms; Catheters; Humans; Proteus Infections; Proteus mirabilis; Urinary Tract Infections

Malacoplakia is a rare chronic inflammatory disease that most commonly involves the genitourinary tract with a wide spectrum of clinical presentation.. A 65-year-old woman presented with obstructive nephropathy with bilateral hydroureteronephrosis. Bilateral nephrostomy-tube placement saw an improvement in her renal function. A computerized tomography (CT) scan with contrast showed suspect lesions in the bladder, which were confirmed by cystoscopy. A transurethral resection of the suspect areas of bladder on histological examination confirmed the diagnosis of malacoplakia. Bilateral ureteral recanalization was performed with placement of ureteral stents, after balloon dilation of strictures. The treatment was continued with ascorbic acid 500 mg daily and ciprofloxacin 500 mg once daily.. Malacoplakia is a rare disease. Treatment is not standard and depends on the disease location. Malacoplakia that is isolated to the lower genitourinary tract, after a transurethral resection indicating to obtain a biopsy and debulking, can typically be treated with medication, whereas upper tract disease commonly requires a combination of medical and surgical intervention.

Topics: Aged; Anti-Bacterial Agents; Ascorbic Acid; Ciprofloxacin; Female; Humans; Hydronephrosis; Malacoplakia; Renal Insufficiency; Stents; Treatment Outcome; Urinary Bladder; Urinary Catheterization; Urinary Tract Infections; Vitamins

This study was aimed to assess the antioxidant enzymatic and non-enzymatic compounds in semen of infertile men. Seventy-four infertile patients were grouped according to their clinical diagnosis: genitourinary infection, varicocele, idiopathic infertility. Semen samples of fertile men represent the control. Semen characteristics were evaluated by light and transmission electron microscopy (TEM). TEM data was quantified with a mathematical formula, which provides numerical scores. Spectrophotometric and HPLC methods were used to measure the amount of reduced (GSH), oxidised glutathione (GSSG), ascorbic acid (AA) and malondialdehyde (MDA, marker of lipid peroxidation) and the activity of glutathione reductase, catalase (CAT), glutathione peroxidase. Infertile groups showed significantly decreased values of sperm parameters vs.. In infection and varicocele groups, the seminal MDA levels were significantly increased when compared to controls (p < 0.001), indicating an alteration of oxidative status and a peroxidative damage. In infection and varicocele groups, AA levels were reduced (p < 0.05) vs. control; in the varicocele group, the GSH levels were also decreased (p < 0.05). Significantly higher CAT activity was observed in infection and varicocele groups vs. fertile men (p < 0.001 and p < 0.05 respectively). The GSH/GSSG ratio was significantly decreased in varicocele and idiopathic infertility groups vs. control (p < 0.01). The study of the alteration of a single parameter of oxidative stress or of the antioxidant system may not have a relevant clinical value to estimate male fertilising potential and the background of infertility causes, since complex and multifactorial mechanisms are involved in different pathologies. In our study, each pathology is characterised by a definite pattern of markers such as MDA and enzymatic and non-enzymatic antioxidant compounds. In the different pathologies related to infertility, the identification of the complex of involved parameters could be useful in the diagnosis, prognosis and in the choice of a possible treatment such as specific antioxidant supplements.

Topics: Adult; Ascorbic Acid; Biomarkers; Catalase; Glutathione; Humans; Infertility, Male; Lipid Peroxidation; Male; Malondialdehyde; Oxidative Stress; Semen; Spermatozoa; Urinary Tract Infections; Varicocele; Young Adult

Urinary tract infections (UTIs) are common in women and many patients with recurrent UTIs do not eradicate the condition albeit being treated with multiple courses of antibiotics. The use of nutritional supplements might reduce the risk of recurrent UTIs. However, the role of supplements taken as single agents appears to be limited. We hypothesized that a combination of cranberries, Lactobacillus rhamnosus, and vitamin C might produce a clinical benefit due to their additive or synergistic effects. We prospectively enrolled 42 consecutive women with recurrent UTIs treated with 120mg cranberries (minimum proanthocyanidin content: 32mg), 1 billion heat-killed L. rhamnosus SGL06, and 750mg vitamin C thrice daily for 20 consecutive d. Patients were advised to stop taking these supplements for 10 d and then to repeat the whole cycle three times. Patients were contacted three mo and six mo following the end of the administration of these supplements and evaluated with a semistructured interview and urinalysis. Responders were defined as the absence of symptoms and negative urinalysis or urine culture. Follow-up data were available for 36 patients. Overall, 26 (72.2%) and 22 patients (61.1%) were responders at the 3-mo and 6-month follow-up. No major side effects were recorded. The administration of cranberries, L. rhamnosus, and vitamin C might represent a safe and effective option in women with recurrent UTIs.. We evaluated the effectiveness of cranberries, Lactobacillus rhamnosus, and vitamin C thrice daily for 20 consecutive d monthly for 3 mo for the management of recurrent urinary tract infections in women. Our results show that this approach might represent a safe and effective option.

Topics: Adult; Aged; Antioxidants; Ascorbic Acid; Dietary Supplements; Female; Humans; Lacticaseibacillus rhamnosus; Middle Aged; Pilot Projects; Prospective Studies; Recurrence; Urinary Tract Infections; Vaccinium macrocarpon; Young Adult

Topics: Anti-Bacterial Agents; Antioxidants; Ascorbic Acid; Bethanechol; Biopsy; Diagnosis, Differential; Female; Fluoroquinolones; Humans; Ill-Housed Persons; Kidney; Kidney Function Tests; Malacoplakia; Middle Aged; Muscarinic Agonists; Organ Size; Prognosis; Renal Dialysis; Renal Insufficiency; Substance-Related Disorders; Tomography, X-Ray Computed; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

Urinary tract infections (UTIs, including upper and lower symptomatic) are the most common infections in nursing homes and prevention may reduce patient suffering, antibiotic use and resistance. The spectre of agents used in preventing UTIs in nursing homes is scarcely documented and the aim of this study was to explore which agents are prescribed for this purpose.. We conducted a one-day, point-prevalence study in 44 Norwegian nursing homes during April-May 2006. Nursing home residents prescribed any agent for UTI prophylaxis were included. Information recorded was type of agent and dose, patient age and gender, together with nursing home characteristics. Appropriateness of prophylactic prescribing was evaluated with references to evidence in the literature and current national guidelines.. The study included 1473 residents. 18% (n = 269) of the residents had at least one agent recorded as prophylaxis of UTI, varying between 0-50% among the nursing homes. Methenamine was used by 48% of residents prescribed prophylaxis, vitamin C by 32%, and cranberry products by 10%. Estrogens were used by 30% but only one third was for vaginal administration. Trimethoprim and nitrofurantoin were used as prophylaxis by 5% and 4%, respectively.. The agents frequently prescribed to prevent UTIs in Norwegian nursing homes lack documented efficacy including methenamine and vitamin C. Recommended agents like trimethoprim, nitrofurantoin and vaginal estrogens are infrequently used. We conclude that prescribing of prophylactic agents for UTIs in nursing homes is not evidence-based.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Ascorbic Acid; Evidence-Based Medicine; Female; Homes for the Aged; Humans; Male; Methenamine; Nursing Homes; Prescription Drugs; Treatment Outcome; Urinary Tract Infections; Vaccinium macrocarpon

To investigate the oxidative and antioxidative status of urine and serum of patients with urinary tract infection (UTI) and to compare them with those of controls.. The antioxidative status of urine and serum were evaluated by measuring total antioxidant capacity (TAC) and plasma vitamin C concentration. The oxidative status of the samples was assessed by measuring the total peroxide and the oxidative stress index (OSI) levels. The means of the parameters were compared and the relationships among them were determined.. Total peroxide and OSI levels were found to be lower and TAC was found to be higher in the urine of patients with UTI. On the contrary, while the plasma vitamin C concentration and TAC of serum was lower, the total peroxide and OSI levels were higher in patients than controls. There was a negative correlation between serum TAC and urine TAC values. There was also a positive correlation between plasma vitamin C concentration and serum TAC levels.. The urine of the patients with UTI have higher TAC and lower total peroxide and OSI levels. However, lower TAC and plasma vitamin C concentration and higher total peroxide and OSI levels were observed in UTI. This condition may be a factor which facilitates the development of the infection or is secondary to UTI.

Topics: Adult; Antioxidants; Ascorbic Acid; Biomarkers; Case-Control Studies; Down-Regulation; Female; Humans; Male; Middle Aged; Oxidative Stress; Peroxides; Urinary Tract Infections; Young Adult

The use of indwelling urinary catheters is a major risk factor for urinary tract infection; and despite the availability of numerous preventive regimens, this condition is still extremely common. In earlier studies we have demonstrated the inhibitory effects of nitrite and ascorbic acid on bacterial growth in urine. When combined, these compounds generate antibacterial reactive nitrogen species, including the gas nitric oxide. We have now tested in a laboratory model of the urinary bladder whether filling of the catheter retention balloon with nitrite and ascorbic acid would generate measurable amounts of NO outside the membrane and whether this would affect bacterial growth in the surrounding urine. Two strains of Escherichia coli, one strain isolated from a patient (U1106024) and one reference strain (ATCC 25922), were tested. Nitric oxide gas was generated in the silicone balloon and readily diffused into the urine. When control catheters with ascorbic acid but without nitrite were used, bacterial counts increased from 9.0 x 10(5) to 2.0 x10(8) CFU/ml (strain U1106024) and from 2.5 x 10(6) to 2.7 x 10(8) CFU/ml (strain ATCC 25922) after 24 h. In contrast, in test catheters with ascorbic acid and nitrite, both strains tested were effectively killed. The NO donor {DETA NONOate, (Z)-1-[N-(2-aminoethyl)-N-(2-ammonioethyl)amino]diazen-1-ium-1,2-diolate} also showed antibacterial activity in the same model, thereby supporting a central role of NO in achieving the observed effects. Future clinical trials will reveal whether this novel approach for the intravesical delivery of an antibacterial gas could be used to prevent catheter-associated infections.

Topics: Administration, Intravesical; Anti-Bacterial Agents; Ascorbic Acid; Catheters, Indwelling; Colony Count, Microbial; Escherichia coli; Escherichia coli Infections; Humans; Laboratories; Models, Anatomic; Nitric Oxide; Nitrites; Urinary Bladder; Urinary Catheterization; Urinary Tract Infections; Urine

Topics: Ascorbic Acid; Diet; Humans; Hydrogen-Ion Concentration; Phytotherapy; Plant Preparations; Risk; Urinary Tract Infections; Urine; Vaccinium macrocarpon

Topics: Adolescent; Ascorbic Acid; Dietary Proteins; Eating; Energy Intake; Female; Female Urogenital Diseases; Humans; Incidence; Iron; Mycoses; Pregnancy; Pregnancy Complications, Infectious; Pregnancy in Adolescence; Sexually Transmitted Diseases; Urinary Tract Infections; Vitamin A; Zinc

The effects of ammonium chloride, methenamine hippurate and ascorbic acid on urinary pH was studied in 14 normal subjects. A statistically significant reduction of urinary pH was recorded with ammonium chloride in daily doses of 1.5 and 3 g, but not with 2 g of methenamine hippurate or 1.8 g of ascorbic acid. Long-term treatment with ammonium chloride in doses between 1.5 and 3 g was given to 11 patients in order to reduce the risk of new stone formation or growth of fragments remaining after disintegration of infected renal stones. Biochemical stone analyses showed struvite in 9 of the treated stones, and urine cultures verified the presence of urease-producing bacteria in 10 patients. Apart from ammonium chloride, the patients were treated with antibiotics, in 4 patients continuously and in the others during periods from 2 to 34 months. The patients were followed for an average period of 32 months. No adverse reactions were recorded with the dosage used. Initially, 6 patients were stone-free, whereas 5 had residual stone fragments with a largest diameter ranging from 4 to 20 mm. At follow-up, 2 patients were still stone-free, and of 5 patients with residual fragments 1 showed stable disease and 3 an improved stone situation. In 5 patients, 3 of whom had residual stone fragments, antibiotic treatment had been interrupted without infectious relapse.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Ammonium Chloride; Anti-Infective Agents, Urinary; Ascorbic Acid; Female; Hippurates; Humans; Hydrogen-Ion Concentration; Kidney Calculi; Male; Methenamine; Middle Aged; Recurrence; Time Factors; Urinary Tract Infections; Urine

We conducted a case-control study to examine the associations between various behavioral risk factors and urinary tract infection among college-aged women. Cases were collected from a University Health Service, and were compared to Health Service controls and to a population-based control group. Sexual intercourse, diaphragm use, and urinating after sexual intercourse were each associated with urinary tract infection (UTI). The magnitude of the association of diaphragm use with UTI was reduced when urination habits around sexual intercourse were considered.. 468 women using the University of Michigan Health Service because of urinary symptoms, completed questionnaires regarding medical history, stress, clothing, diet, sexual activity, and birth control method during the previous 4 weeks. 1484 potential Health Service controls without urinary symptoms were selected as well as 115 student-population -based controls. Urinary tract infection (UTI) criteria were 100,000 colonies of bacteria/ml urine and 10,000 colonies of a single bacteria/ml urine. After exclusions, the sample numbered 1641 women: 237 UTI cases, 1296 Health Service controls, and 108 student-population controls with an average age of 21.9 years. 63.2% of cases, 36.4% of Health Service controls, and 25.2% of population controls reported previous UTIs. UTIs significantly increased with the frequency of sexual intercourse. There was a weak link between a new sexual relationship in the prior 4 weeks and UTI and no association between multiple partners and UTI. Women without UTI used a diaphragm with spermicides (DIS) 8 times more often than oral contraceptives (OCs) compared to controls. Women who had had 1 or 2 UTIs used the DIS twice as often as OCs. Cases were more likely never of rarely to urinate after intercourse than controls. Always urinating before or after intercourse tended to protect against UTI. The odds ratio (OR) among women without UTI using a D/S urinating only before was 3.4, less than the OR of 9.5 associated with constant urination habits. The OR with D/S use before and after. Vitamin C appeared to protect against UTI, and the stress scale was somewhat linked to UTI. Sexual intercourse, D/S use, and urinating after sex (among women without previous UTI incidence) were associated with UTI.

Topics: Adult; Ascorbic Acid; Case-Control Studies; Clothing; Coitus; Contraceptive Devices, Female; Diet; Female; Humans; Hygiene; Michigan; Recurrence; Regression Analysis; Retrospective Studies; Risk Factors; Surveys and Questionnaires; Urinary Tract Infections; Urination

Topics: Adult; Anti-Bacterial Agents; Ascorbic Acid; Bethanechol Compounds; Chronic Disease; Escherichia coli Infections; Female; Humans; Malacoplakia; Urinary Tract Infections

The influence of orally administered ascorbic acid on the urinary pH of 10 healthy volunteers and 10 patients with infected urine was investigated. During a four-day period of investigation urinary pH and the concentration of ascorbic acid in the respective urines were measured five times a day. On the second and third day three times a dose of 2 g ascorbic acid was given, while the diet was under control all four days. A correlation between pH decrease and ascorbic acid concentration is only observed if the concentration of the latter is higher than 200 mg%. The mean decrease in urinary pH between days with ascorbic acid supply and days without is -0,16 pH units for the volunteers respectively -0,18 pH units for the patients. Therefore, vitamin C can not be recommended to lower the pH of alkaline urines.

Topics: Administration, Oral; Ascorbic Acid; Humans; Hydrogen-Ion Concentration; Urinary Tract Infections; Urine

The acidifying effect of intravenous (IV) ascorbic acid was studied in seven healthy adult volunteers. After obtaining baseline urine and blood samples, 2-g IV doses of ascorbic acid were administered to each subject during a 20-minute period. Venous blood samples were obtained at times 0.5, 1, and 2 hours, and urine was collected at times 0.5, 1, 2, and 3 hours. Our results show that venous blood pH, plasma bicarbonate concentration, urine PCO2, and urine bicarbonate excretion did not change significantly during the study period. Urinary titratable acidity, ammonium excretion, and net hydrogen ion excretion decreased, and urinary pH actually showed a significant rise at two hours. We therefore conclude that IV ascorbic acid administered in recommended doses does not effectively acidify urine.

Topics: Acid-Base Equilibrium; Acids; Adult; Ascorbic Acid; Female; Humans; Male; Urinary Tract Infections; Urine

The intermittent bladder catheterization technique has been proposed as an effective way of eliminating the need for an inlying. Foley catheter in patients with neurovesical dysfunction following spinal cord injury. In the study reported here, a group of 41 male patients with spinal cord injuries achieved a catheter-free state with this method. Of these 41 patients, 19 have been followed for 1 year. Data obtained from the 19 patients are presented here for comparison with data from other recent studies. In the present study, the patients' fluid intake was restricted to 2,000 cc daily. A detrusor reflex was triggered by lower abdominal percussion followed by a Credé maneuver. A 6-hour catheterization schedule was used unless autonomic dysreflexia required more frequent catheterizations. Ascorbic acid, methenamine mandelate and nitrofurantoin were routinely administered, and specific antibiotics were also given following trial off-catheter, depending on the results of urine cultures and sensitivity studies. All patients achieved a catheter-free state in an average time of 17.1 days; no late failures have occurred. Two patients developed vesicoureteral reflux, but no evidence of hydronephrosis was observed. At 1 year only 16% of the patients were found to have infected urine, as compared to 100% at initiation of the trial off-catheter.

Topics: Ascorbic Acid; Female; Follow-Up Studies; Humans; Methenamine; Nitrofurantoin; Spinal Cord Injuries; Time Factors; Urinary Bladder, Neurogenic; Urinary Catheterization; Urinary Tract Infections; Urine

Methenamine is frequently prescribed for patients who have chronic urinary infection to suppress bacterial growth during active infection or to prevent recurrence once an infection has been brought under control. We have examined the effect of methenamine mandelate and ascorbic acid on bacteriuria in para- and quadriplegics from a spinal cord unit. Patients with indwelling urinary catheters and those on a program of intermittent catheterization were included. No suppressive or prophylactic effect of this regimen was observed in any of our patients. Methenamine does not appear to be an effective antimicrobial agent in subjects who have an indwelling urinary catheter or in patients with spinal cord injury who are on intermittent catheterization. Since there appears to be reason to question the efficacy of methenamine in situations in which it is usually prescribed, evidence should be sought for a therapeutic effect in other cases. If no benefit is observed, the drug should not be used.

Topics: Ascorbic Acid; Catheters, Indwelling; Chronic Disease; Drug Therapy, Combination; Humans; Male; Methenamine; Urinary Catheterization; Urinary Tract Infections

Topics: Aged; Ascorbic Acid; Chronic Disease; Female; Hippurates; Humans; Hydrogen-Ion Concentration; Male; Methenamine; Urinary Catheterization; Urinary Tract Infections

Topics: Academies and Institutes; Adult; Ascorbic Acid; Child; Child, Preschool; Common Cold; Evaluation Studies as Topic; Female; Fetus; Humans; Hydrogen-Ion Concentration; Infant; Infant, Newborn; Pediatrics; Pregnancy; Urinary Calculi; Urinary Tract Infections; Urine

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: Acidosis; Ammonium Chloride; Ascorbic Acid; Betaine; Evaluation Studies as Topic; Humans; Hydrochloric Acid; Hydrogen-Ion Concentration; Lysine; Pepsin A; Urinary Calculi; Urinary Tract Infections; Urine

Topics: Angiography; Animals; Ascorbic Acid; Blood Vessels; Cats; Female; Humans; Intervertebral Disc; Male; Methenamine; Motor Neurons; Myelography; Nerve Tissue; Neuroradiography; Paraplegia; Pressure; Quadriplegia; Rabbits; Spinal Canal; Spinal Cord Compression; Spinal Cord Injuries; Spinal Cord Neoplasms; Urinary Catheterization; Urinary Tract Infections; Urination Disorders; Urologic Diseases

Topics: Ascorbic Acid; Costs and Cost Analysis; Humans; Methenamine; Nitrofurantoin; Urinary Tract Infections

Topics: Adult; Ascorbic Acid; Blood Cell Count; Creatinine; Female; Folic Acid; Hematocrit; Hemoglobinometry; Humans; Kidney Failure, Chronic; Male; Methemoglobin; Middle Aged; Neural Conduction; Nitrofurantoin; Peripheral Nerves; Reticulocytes; Urinary Tract Infections

Topics: Acidosis, Renal Tubular; Adult; Aged; Ammonium Chloride; Ascorbic Acid; Enterobacter; Humans; Hydrochloric Acid; Hydrogen-Ion Concentration; Klebsiella Infections; Middle Aged; Proteus Infections; Pseudomonas Infections; Urinary Tract Infections; Urine

Topics: Adult; Ascorbic Acid; Carbon Dioxide; Carbon Isotopes; Erythrocytes; Erythrocytes, Abnormal; Female; Glucose; Glucosephosphate Dehydrogenase; Glucosephosphate Dehydrogenase Deficiency; Glutathione; Glutathione Reductase; Heinz Bodies; Hemolysis; Hexosephosphates; Humans; Methylene Blue; Peroxidases; Peroxides; Pyruvate Kinase; Sodium Chloride; Urinary Tract Infections

Topics: Ampicillin; Ascorbic Acid; Child; Child, Preschool; Female; Humans; Male; Methenamine; Nephrosis; Nephrotic Syndrome; Penicillin Resistance; Penicillins; Prednisone; Triamcinolone; Urinary Tract Infections

Topics: Antineoplastic Agents; Ascorbic Acid; Carcinogens; Hemorrhage; Humans; Lymph Node Excision; Urinary Bladder; Urinary Bladder Neoplasms; Urinary Tract Infections

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Bethanechol Compounds; Humans; Male; Methenamine; Middle Aged; Paraplegia; Parasympathomimetics; Spinal Cord Injuries; Urinary Catheterization; Urinary Tract Infections; Urine

Topics: Anti-Bacterial Agents; Antitubercular Agents; Ascorbic Acid; Bacteria; Cholera; Dapsone; Dysentery, Bacillary; Female; Heterocyclic Compounds; Humans; Leprosy; Meningitis; Meningitis, Haemophilus; Methods; Otorhinolaryngologic Diseases; Pregnancy; Puerperal Infection; Scarlet Fever; Sulfathiazoles; Sulfones; Tuberculosis, Meningeal; Tuberculosis, Pulmonary; Urinary Tract Infections; Vitamin K

Topics: Ascorbic Acid; Drug Therapy; Humans; Methenamine; Methionine; Urinary Tract Infections

Topics: Anti-Bacterial Agents; Ascorbic Acid; Drug Resistance, Microbial; Humans; Hydrogen-Ion Concentration; Nitrofurantoin; Urinary Tract Infections; Urine

Topics: Anti-Infective Agents, Urinary; Ascorbic Acid; Humans; Methenamine; Urinary Tract; Urinary Tract Infections; Urologic Diseases