trimethoprim--sulfamethoxazole-drug-combination and Urinary-Bladder-Neoplasms

Nephrogenic adenoma is an uncommon urothelial lesion that has been associated with chronic inflammation and surgical manipulation of the urinary tract. Several cases of vesical nephrogenic adenoma in patients with a history of renal transplantation have been reported. The present case report reviewed the management of recurrent nephrogenic adenoma in a 6-year-old boy with history of renal transplantation 3 years before the diagnosis of nephrogenic adenoma. After multiple surgical resections for recurrent nephrogenic adenoma, the lesion finally resolved with long-term treatment with ibuprofen (Motrin) and trimethoprim and sulfamethoxazole (Septra).

Topics: Adenoma; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Biopsy; Child; Endoscopy; Humans; Ibuprofen; Inflammation; Kidney Transplantation; Male; Recurrence; Renal Insufficiency; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Bladder Neoplasms

Nocardia is a rare pathogen of mainly immunocomprised patients. Only two cases of nocardiosis have previously been identified in Iceland.. A 92-year-old male on glucocorticoid therapy with metastatic bladder cancer presented with two weeks history of progressive swelling and erythema of the hand and deteriorating cognitive functioning. A brain lesion and pulmonary nodules were identified and Nocardia farcinia was cultured from a hand abscess. The patient was initially treated with trimethoprim/sulfamethoxazole but because of rapid deterioration and old age an end-of-life decision was made.. This case of nocardiosis illustrates the importance of uncommon opportunistic infections in immunocompromised Icelandic patients.

Topics: Aged, 80 and over; Anti-Infective Agents; Cellulitis; Edema; Erythema; Glucocorticoids; Hand; Humans; Immunocompromised Host; Male; Nocardia; Nocardia Infections; Opportunistic Infections; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Bladder Neoplasms

The recurrence rate for superficial bladder tumors treated with complete resection averages 88%. Intravesical chemotherapy decreases the recurrence rate by only 14%; thus, new chemotherapeutic agents are needed. Antibiotics are often used to prevent infections after transurethral resection of bladder tumors. Oral intake of antibiotics results in significantly greater concentrations in the urine than in the serum. Our objective was to evaluate four commonly used urinary antibiotics for their cytotoxic activity against bladder cancer cells at clinically relevant concentrations.. Three human transitional cell carcinoma lines--HTB9 (grade 2), T24 (grade 3), and TccSup (grade 4)--were exposed to ciprofloxacin, trimethoprim-sulfamethoxazole, cefazolin, or nitrofurantoin at concentrations from 0 (control) to 1000, 1000, 5000, and 2000 microg/mL, respectively, for 96 hours. Cytotoxicity was evaluated using the MTT colorimetric assay. Six replicates were used for each data point, and the results are reported as the mean +/- standard deviation.. Significant cytotoxicity (P <0.001) was seen, starting at 12.5 microg/mL (HTB9, TccSup) and 50 microg/mL (T24) for ciprofloxacin, 31.25 microg/mL (HTB9, TccSup) and 62.5 microg/mL (T24) for trimethoprim-sulfamethoxazole, 19.5 microg/mL (HTB9) and 156.3 microg/mL (T24, TccSup) for cefazolin, and 7.8 microg/mL (HTB9, T24, TccSup) for nitrofurantoin. Cytotoxicity was dose dependent for all four antibiotics, and the maximal effect did not differ among antibiotics.. Commonly used antibiotics exhibit significant dose-dependent cytotoxicity against bladder cancer cells at concentrations achievable in the urine after oral administration. The administration of antibiotics after transurethral resection of bladder tumors might prevent seeding of cancer cells and thereby decrease the recurrence rate. Preclinical data such as these must be considered in the design of clinical trials addressing recurrence after transurethral resection of bladder tumors.

Topics: Antibiotics, Antineoplastic; Carcinoma, Transitional Cell; Cefazolin; Cell Line, Tumor; Ciprofloxacin; Dose-Response Relationship, Drug; Drug Screening Assays, Antitumor; Genes, p53; Humans; Nitrofurantoin; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Bladder Neoplasms

Hematogenous spread of bacillus Calmette-Guerin (BCG) after intravesical instillation for bladder cancer is rare but it may result in systemic infection and hypersensitivity reaction. We investigated fluoroquinolones and steroids in an animal model to improve the therapeutic options in local and systemic BCG infection. Furthermore, the antitumor effectiveness of intravesical BCG with simultaneous application of fluoroquinolones and/or steroids was tested.. Oral antimicrobial therapy with and without steroids was started immediately after intraperitoneal injection using fluoroquinolones or trimethoprim-sulfamethoxazole. To evaluate the therapeutic options against a hyperergic reaction after repeat systemic BCG infection re-challenge was performed with intraperitoneal BCG 7 days after primary infection and oral therapy was given with fluoroquinolones or trimethoprim-sulfamethoxazole with and without steroids. The influence of continuous oral fluoroquinolone therapy on the antitumor effect of BCG was also tested in the MB 49 orthotopic murine bladder tumor model.. After primary systemic infection fluoroquinolone therapy alone led to significantly prolonged survival in mice (log rank test p = 0.041), whereas trimethoprim-sulfamethoxazole was ineffective. There was no additional effect of steroid administration. Steroids alone led to premature death (log rank test p = 0.022). After secondary BCG infection only steroid treated animals had prolonged survival (log rank test p = 0.032), whereas antimicrobials alone had no effect. The therapeutic efficacy of BCG in the orthotopic bladder tumor model was not affected by continuous oral fluoroquinolones in terms of survival (log rank test p = 0.001) or bladder weight (Wilcoxon test p = 0.001) compared with untreated controls.. In a mouse model fluoroquinolones had a beneficial effect for primary systemic BCG infections, whereas the hyperergic reaction after repeat BCG infection was susceptible only to steroids. Administering fluoroquinolones during an intravesical treatment course does not affect the antitumor efficacy of BCG.

Topics: Animals; Cell Survival; Ciprofloxacin; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Injections, Intraperitoneal; Mice; Mice, Inbred C57BL; Mycobacterium bovis; Ofloxacin; Prednisolone; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Tuberculosis; Tumor Cells, Cultured; Urinary Bladder Neoplasms; Virulence

Three children aged 3-11 years had ultrasonography of the urinary tract for the investigation of dysuria and haematuria. A bladder mass was seen in these 3 children. One child had computed tomography scan, cystoscopy and bladder biopsy because rhabdomyosarcoma was considered. The biopsy revealed an inflammatory process. The urine culture of the other 2 children revealed E. coli. On ultrasonography, the inflammatory mass may appear homogeneously hypoechoic or may contain moderate level echoes. The mucosal surface of the mass may be smooth or lobulated. It is important to consider an infective cause for a bladder mass in children because computed tomography, cystoscopy and biopsy may be avoided.

Topics: Anti-Infective Agents, Urinary; Child; Child, Preschool; Cystitis; Diagnosis, Differential; Female; Hematuria; Humans; Male; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography; Urinary Bladder Neoplasms; Urination Disorders

This is a case report on a 70-year-old male patient. During chemotherapy treatment after a bladder tumor operation, the patient had a complication of pneumonia which did not respond to various antibiotics. From clinical observations and chest X-ray, it was diagnosed as pneumocystis carinii (PC) pneumonia and was cured by medication of Co-trimoxazole.

Topics: Aged; Carcinoma, Transitional Cell; Doxorubicin; Drug Combinations; Humans; Male; Pneumonia, Pneumocystis; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Bladder Neoplasms