colistin and Spinal-Cord-Injuries

An open, prospective, randomised, comparative study of "Trisdine" and kanamycin-colistin bladder instillations in reducing significant bacteriuria during intermittent urethral catheterisation was conducted. Trisdine is an aqueous solution of chlorhexidine gluconate 0.01% with added ethylenediaminetetra-acetic acid disodium salt and TRIS buffer at final concentrations of 1.34 mMoles and 0.01 Molar respectively. All patients (15 males and 3 females) admitted with acute spinal cord trauma and bladder involvement requiring intermittent catheterisation for more than 5 days during a 12-month period were studied. There was no significant difference in the mean incidence of significant bacteriuria during intermittent catheterisation in the 7 males who had kanamycin-colistin bladder instillations compared with the 8 males who had Trisdine instillations. A comparison could not be made in the females because there were only 3 patients. Because Trisdine is more stable at ambient temperatures, is less likely to select antibiotic-resistant bacteria and is less expensive, it is concluded that Trisdine is preferable to kanamycin-colistin solution for bladder instillations during intermittent catheterisation.

Topics: Acute Disease; Adolescent; Adult; Anti-Infective Agents, Urinary; Bacteriuria; Chlorhexidine; Clinical Trials as Topic; Colistin; Drug Combinations; Edetic Acid; Female; Humans; Kanamycin; Male; Middle Aged; Prospective Studies; Random Allocation; Spinal Cord Injuries; Tromethamine; Urinary Catheterization

Two groups of patients with acute spinal cord trauma had initial bladder management by standard non-touch techniques of intermittent catheterisation. Twenty-two patients (17 males and 5 females) had kanamycin-colistin solution instilled into the bladder at the end of each catheterisation, and 25 patients (21 males and 4 females) were not given these instillations. The incidence of significant bacteriuria during intermittent catheterisation of both males and females receiving the instillations was only half the incidence of those not receiving the instillations. Also, a significantly higher proportion of males receiving the instillations did not have any episodes of significant bacteriuria compared with those not receiving the instillations, and the same trend was evident in the small number of female patients. It is recommended that patients should have kanamycin-colistin bladder instillations when they are being intermittently catheterised.

Topics: Acute Disease; Bacteria; Bacteriuria; Colistin; Drug Combinations; Female; Humans; Kanamycin; Male; Microbial Sensitivity Tests; Solutions; Spinal Cord Injuries; Urinary Bladder; Urinary Catheterization

Topics: Colistin; Female; Humans; Kanamycin; Male; Spinal Cord Injuries; Urinary Bladder Diseases; Urinary Catheterization; Urinary Tract Infections

Topics: Australia; Colistin; Female; Humans; Kanamycin; Male; Paraplegia; Prognosis; Quadriplegia; Spinal Cord Injuries; Urinary Bladder, Neurogenic; Urinary Catheterization; Urinary Tract Infections