cefuroxime-axetil and Urinary-Tract-Infections

Topics: Cefuroxime; Cephalosporins; Humans; Prodrugs; Urinary Tract Infections

The optimal duration of antibiotic therapy in children with febrile urinary tract infections (UTIs) is still a matter of debate. Current guidelines recommend treating children with febrile UTIs with antimicrobials for 7 to 14 days. We aim to compare the efficacy and safety of 7-day versus 10-day course of oral or sequence therapy (intravenous with a switch to oral) with cefuroxime/cefuroxime axetil for febrile UTIs in children.. A non-inferiority, double-blind, randomised, controlled trial will be conducted. Two hundred twenty-one patients aged 3 months to 7 years with febrile UTIs (defined as a combination of fever and leucocyturia in urine sediment) will be randomly assigned to a 7-day treatment arm (7 days of cefuroxime/cefuroxime axetil followed by 3 days of blinded placebo) or a 10-day treatment arm (7 days of cefuroxime/cefuroxime axetil followed by 3 days of blinded cefuroxime axetil). The primary outcome measure will be frequencies of recurrence and reinfection of UTI during the 6 months after the intervention.. The Bioethics Committee approved the study protocol. The findings of this trial will be submitted to a peer-reviewed paediatric journal. Abstracts will be submitted to relevant national and international conferences.. 04/09/2017 TRIAL REGISTRATION NUMBER: NCT03221504.

Topics: Anti-Bacterial Agents; Cefuroxime; Child; Child, Preschool; Double-Blind Method; Drug Administration Schedule; Female; Fever; Humans; Infant; Leukocytes; Male; Research Design; Urinary Tract Infections

To compare the efficacy of fosfomycin trometamol, cefuroxime axetil, and amoxicillin clavulanate antibiotics, and to assess the difference in patient compliance, in the treatment of urinary tract infections during pregnancy.. Between September 2007 and May 2008, 90 out of 324 pregnant women with complaints of lower urinary tract infection, who were followed at the outpatient clinic or referred to the emergency department of Vakif Gureba Education and Research Hospital, were enrolled in a prospective study. Patients were randomized into 3 equal groups for treatment with single-dose fosfomycin trometamol, or 5-day courses of amoxicillin clavulanate or cefuroxime axetil. After follow-up, study data were obtained for 28, 27, and 29 patients, respectively.. The treatment groups did not differ significantly in terms of demographics, clinical success rate, microbiological cure rate, or adverse effects. Significantly higher drug compliance was observed in the fosfomycin trometamol group than in the other 2 groups (P<0.05).. Treatment with a single dose of fosfomycin trometamol was as effective for UTI as the standard course of treatment with amoxicillin clavulanate or cefuroxime axetil. Fosfomycin trometamol may be a preferable treatment for UTI because of its simpler use and better rates of compliance.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cefuroxime; Female; Fosfomycin; Humans; Patient Compliance; Pregnancy; Pregnancy Complications, Infectious; Urinary Tract Infections; Young Adult

There are controversies in the literature regarding the need for and duration of antibiotic prophylaxis in patients treated with extracorporeal shock wave lithotripsy (ESWL) who have a negative urine culture before treatment. In order to determine the efficacy of antibiotic prophylaxis in ESWL treatment of patients with proven sterile urine, a randomized trial was performed.. Patients were randomized for placebo and 1 or 7 days antibiotic prophylaxis (cefuroxime or ciprofloxacin), starting 30 min before ESWL. Post-ESWL studies (immediately and 2 and 6 weeks after ESWL) included patient history, urine culture and Gram stain.. After 2 weeks 20% of the patients and after 6 weeks 23% of the patients had bacteriuria, but there was no statistical significance between patients treated with placebo or those receiving prophylactic treatment. Only 2-3% of the patients (in the prophylaxis and placebo group) had clinical and bacteriological signs of a urinary tract infection, either 2 or 6 weeks after ESWL, possibly caused by re-infection, however, since bacteria were found in none of the urine samples collected directly after ESWL. There was no beneficial effect of antibiotic prophylaxis, in the prevention of urinary tract infections in patients with a nephrostomy catheter or dilatation at the site of treatment.. We conclude that in patients with urine proven sterile prior to ESWL there is no need for antibiotic prophylaxis.

Topics: Administration, Oral; Anti-Infective Agents; Antibiotic Prophylaxis; Cefuroxime; Cephalosporins; Ciprofloxacin; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Injections, Intravenous; Lithotripsy; Male; Middle Aged; Prospective Studies; Time Factors; Ureteral Calculi; Urinary Tract Infections

Short-course therapy for pediatric urinary tract infection (UTI) remains controversial. The present study was undertaken to compare the effectiveness of cefuroxime axetil (Ceftin) as short-course (2-day) versus conventional (10-day) therapy for uncomplicated pediatric UTIs. In a randomized, controlled, prospective study, we enrolled 50 children, 2-11 years of age, to receive oral cefuroxime axetil, 125 mg twice a day, for either 2 or 10 days. UTI was defined as at least 10(5) colonies/ml of a single pathogen isolated on clean catch, or at least 10(4) colonies/ml on a catheterized specimen. A 10-fold or greater reduction in colony count of the initially isolated organism (3-5) days after stopping therapy was considered a bacteriologic success, as long as the absolute colony count was below the threshold for UTI described above. Patients were followed for 15 months with multiple repeat urine cultures and radiologic studies. Twenty-five of the 50 patients enrolled were withdrawn, including 12 for initially inadequate colony counts. Eight of 12 patients in the short-course group (67%), versus 12 of 14 in the conventional-therapy group (86%), were initial bacteriological successes, a nonsignificant difference. All 37 initially isolated uropathogens were sensitive to cefuroxime axetil in vitro. Cefuroxime axetil is an effective antimicrobial for uncomplicated pediatric UTIs. Two-day therapy with cefuroxime axetil appears to be as effective as 10-day therapy, although sample size was limited in this study.

Topics: Administration, Oral; Cefuroxime; Child; Child, Preschool; Colony Count, Microbial; Drug Administration Schedule; Escherichia coli; Escherichia coli Infections; Female; Humans; Male; Prodrugs; Prospective Studies; Time Factors; Urinary Tract Infections

In patients with a history of recurrent infections, treatment with enoxacin (200 mg/12 h for 3 days) relieved symptoms of acute urinary infection significantly more rapidly than treatment with cefuroxime axetil (125 mg/12 h for 7 days). Other parameters, including clinical and bacteriological cure rates and patients' overall opinion of their treatment, did not differ significantly between the treatments.

Topics: Adult; Aged; Aged, 80 and over; Cefuroxime; Enoxacin; Humans; Middle Aged; Prodrugs; Urinary Tract Infections

Topics: Bacteriuria; Cefuroxime; Colony Count, Microbial; Escherichia coli Infections; Female; Humans; Mass Screening; Prodrugs; Treatment Outcome; Urinary Tract Infections; Urine

Female patients presenting to their general practitioner with symptoms of uncomplicated urinary tract infection (cystitis) were entered into one of three therapeutic trials in a study programme of cefuroxime axetil (125 mg twice daily or 250 mg twice daily) conducted throughout the United Kingdom. On entry to the study, demographic information, infection recurrence rate and clinical signs and symptoms were recorded and the patient given medication for 7-days' treatment. Post-treatment, clinical signs and symptoms were re-assessed and adverse event data collected. Of the 672 patients who entered the programme, 605 patients completed the course of treatment of whom 510 were taking the 125 mg and 95 taking the 250 mg dosage. No significant difference in clinical efficacy or adverse events was found between the two dosage regimens. Analysis of the changes in symptom severity from the pre-treatment to the post-treatment evaluation for all patients showed a highly significant improvement (p less than 0.001). One hundred and five (15.6%) of the patients who entered the study reported a total of 132 adverse events, 16 of whom were withdrawn from treatment. The most frequent event was diarrhoea/loose motions. This study shows that cefuroxime axetil appears to be effective and well-tolerated for the treatment of cystitis in general practice.

Topics: Adult; Aged; Cefuroxime; Cystitis; Female; Humans; Middle Aged; Prodrugs; Urinary Tract Infections

Topics: Bacterial Infections; Cefuroxime; Cephalosporins; Clinical Trials as Topic; Dose-Response Relationship, Drug; Humans; Prodrugs; Respiratory Tract Infections; Urinary Tract Infections

Eighty-nine college women with acute urinary tract infections were treated orally with either 1,000 mg of cefuroxime axetil in a single dose (n = 59) or 250 mg of cefaclor three times a day for 7 days (n = 30). At 1 week posttherapy, 88% of the patients in the cefuroxime axetil group and 97% in the cefaclor group were clinically and bacteriologically cured (P greater than 0.10). There was no statistically significant difference between the cure rates of the two treatment groups. However, this study has only a 50% power to detect a 10% difference. Therefore, there is a substantial possibility of a type II error, i.e., failing to find a difference that is actually present. At 4 weeks posttherapy, 78% of the patients in the cefuroxime group and 80% in the cefaclor group remained cured. By 36 weeks posttherapy, the cumulative rate of recurrence in both treatment groups was 60%. Of the patients with a positive antibody-coated bacteria test, fewer achieved a short-term cure after single-dose treatment with cefuroxime axetil than those with a negative antibody-coated bacteria test (67 versus 96%; P less than 0.01).

Topics: Acute Disease; Adult; Blood Chemical Analysis; Cefaclor; Cefuroxime; Cephalexin; Cephalosporins; Female; Humans; Urinary Tract Infections

Cefuroxime axetil (CAE) is an acetoxyethyl ester prodrug of cefuroxime. The efficacy and safety of cefuroxime axetil was studied in a randomized general practice trial in urological infections where cefuroxime axetil 250 mg b.d. was compared with amoxycillin/clavulanate (Augmentin, AUG) 375 mg t.d.s. A randomized trial was then performed in hospital outpatients, who received cefuroxime axetil 250 mg b.d. or cefaclor (CCL) 250 mg t.d.s. Of 140 clinically assessable patients, 108 were cured and 28 improved on cefuroxime axetil (97% success) compared with 75 cured and 13 improved out of 89 on Augmentin (99% success) and 31 cured and 7 improved out of 38 patients treated with cefaclor (97% success). Bacteriology was assessable in 101 patients given cefuroxime axetil (72% cleared), 61 of those given Augmentin (70% cleared) and 27 out of 28 (96%) given cefaclor. As expected, the predominant pathogen was E. coli, accounting for 61% of isolates overall. Drug-related adverse events occurred in 10% of patients given cefuroxime axetil, including diarrhoea in 4%. Eleven percent of patients given Augmentin suffered adverse events (5% diarrhoea) and 5% of those given cefaclor. Superinfections occurred in 4 cefaclor patients (2 Pseudomonas aeruginosa, 1 Candida, 1 E. coli) compared with 2 on cefuroxime axetil (1 Candida, 1 E. coli). Uncomplicated UTI accounted for 92% of cases in the G.P. trial and 82% of cases in the hospital trial. Cefuroxime axetil may be used safely and effectively to treat uncomplicated UTI at a dose of 250 mg b.d.

Topics: Adolescent; Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Cefaclor; Cefuroxime; Cephalosporins; Clavulanic Acids; Clinical Trials as Topic; Drug Combinations; Female; Humans; Male; Middle Aged; Random Allocation; Urinary Tract Infections

Women with recurrent urinary tract infections treated with cefuroxime axetil (500 or 250 mg twice daily) for 7 days had a higher relapse rate when tested 6 weeks after the start of treatment than those given amoxycillin (250 mg three times daily). The poor performance of cefuroxime axetil is explained by variable bioavailability.

Topics: Amoxicillin; Biological Availability; Cefuroxime; Cephalosporins; Female; Follow-Up Studies; Humans; Urinary Tract Infections

Toxic epidermal necrolysis (TEN) is one of the most threatening adverse reactions to various drugs. No case of concomitant occurrence TEN and severe granulocytopenia following the treatment with cefuroxime has been reported to date. Herein we present a case of TEN that developed eighteen days of the initiation of cefuroxime axetil therapy for urinary tract infection in a 73-year-old woman with chronic renal failure and no previous history of allergic diathesis. The condition was associated with severe granulocytopenia and followed by gastrointestinal hemorrhage, severe sepsis and multiple organ failure syndrome development. Despite intensive medical treatment the patient died. The present report underlines the potential of cefuroxime to simultaneously induce life threatening adverse effects such as TEN and severe granulocytopenia. Further on, because the patient was also taking furosemide for chronic renal failure, the possible unfavorable interactions between the two drugs could be hypothesized. Therefore, awareness of the possible drug interaction is necessary, especially when given in conditions of their altered pharmacokinetics as in case of chronic renal failure.

Topics: Aged; Agranulocytosis; Anti-Bacterial Agents; Cefuroxime; Fatal Outcome; Female; Humans; Kidney Failure, Chronic; Stevens-Johnson Syndrome; Urinary Tract Infections

Topics: Aged, 80 and over; Angina, Unstable; Anti-Bacterial Agents; Cefuroxime; Coronary Vasospasm; Diagnosis, Differential; Drug Hypersensitivity; Frail Elderly; Humans; Injections, Intramuscular; Male; Syndrome; Urinary Tract Infections

Choices of antibacterial for infections in pregnancy are limited because of potential risks to the fetus, particularly in the early months. However, infections may result in preterm labour or other problems and so treatment is needed. Increasingly, resistance is reported among common pathogens to older agents, such as ampicillin or amoxicillin, that have been widely used in pregnancy.. To assess the safety and efficacy of cefuroxime axetil in the treatment of infections during pregnancy.. This was a retrospective analysis of case records for women who were treated with cefuroxime axetil at some point during pregnancy.. Patients were treated at one centre in Lubliniec, Poland in 1996 and 1997.. The study included 78 women aged 19 to 38 years (mean 26 years) and their 80 infants.. Efficacy in treating maternal infections was assessed, and the physical and mental development of children born to treated mothers was evaluated for at least 18 months after birth. 13 women were treated in the first trimester, 19 in the second trimester and 46 in the third trimester. There were no abnormalities causing concern in terms of physical or mental development in any of the children, and no abnormality that was attributable to the treatment the mother had received.. The results add clinical support for the use of cefuroxime axetil in pregnancy if an antibacterial is needed, thus offering an alternative if antibacterial resistance to older agents is an issue for the pregnant mother.

Topics: Adult; Cefuroxime; Cephalosporins; Child Development; Female; Fetus; Follow-Up Studies; Humans; Infant; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Infectious; Retrospective Studies; Urinary Tract Infections

The pharmacokinetics of cefuroxime axetil (RS3 formulation) were studied in 20 elderly patients following admission for lower respiratory or urinary tract infection. The mean age was 83.9 years. A 12-hourly dose of 250 mg was given for five days. The mean time to attain maximum serum concentration was 3.2 h with a mean peak concentration of 8.5 mg/l. The mean serum elimination half-life was 3.5 h and the AUC0-infinity 60.4 mg/h.l. There was no accumulation of the drug in the patients studied after five days treatment. The data suggest that the standard dosage regimen is adequate in the sick elderly patient.

Topics: Administration, Oral; Aged; Aged, 80 and over; Cefuroxime; Drug Administration Schedule; Female; Humans; Male; Respiratory Tract Infections; Urinary Tract Infections

Topics: Adult; Aged; Cefuroxime; Female; Follow-Up Studies; Humans; Middle Aged; Prodrugs; Recurrence; Tablets; Urinary Tract Infections

Topics: Bacterial Infections; Cefuroxime; Cephalosporins; Drug Resistance, Microbial; Humans; Prodrugs; Respiratory Tract Infections; Urinary Tract Infections

Cefuroxime axetil in a single daily dose of 250 mg for ten days was given to 75 women with symptoms of acute uncomplicated urinary tract infections. Fifty-nine women were found to have significant bacteriuria but one was excluded as urethral catheterization was required. The dose was taken at night with a milk drink. Ninety-five per cent of women had a clear urine during treatment. Compliance studies showed that antimicrobial activity was detectable in early morning urines up to 8-10 h after the dose. Post treatment, 93% of women were clear of their original infecting organism but five women had become reinfected with a different strain of Escherichia coli. At the six week follow up 98% of women were still clear although one further reinfection had occurred. The overall cure rate was 86%, including 11% reinfection. Adverse events developed in 17 (23%) of the 75 women with candida vaginitis (8) and diarrhoea (4) being most common. Cefuroxime axetil is a valuable therapy for the treatment of urinary tract infection particularly when due to beta-lactamase producing bacteria.

Topics: Acute Disease; Cefuroxime; Cephalosporins; Female; Humans; Urinary Tract Infections

Cefuroxime axetil, an orally absorbed pro-drug of cefuroxime was used to treat a mainly elderly group of patients with symptomatic urinary tract infections. The drug was clinically effective and the bacteriological short term and long term cure rates (55% and 48% respectively) comparable to those of other antibiotics. The study had to be terminated however after the development of three cases of antibiotic associated colitis. Studies of the pharmacokinetics of the drug in volunteers gave inconsistent results suggesting that there may be variable bioavailability of the compound.

Topics: Administration, Oral; Adolescent; Adult; Aged; Bacteria; Biological Availability; Cefuroxime; Cephalosporins; Humans; Kinetics; Microbial Sensitivity Tests; Middle Aged; Urinary Tract Infections