trimethoprim--sulfamethoxazole-drug-combination and Urinary-Calculi

A randomised clinical study was carried out on patients admitted for ESWL treatment in order to establish the requirement for prophylactic treatment with antibiotics during this procedure. Patients with clinical signs of urinary tract infection, evidence of infectious stones or a positive urine culture were excluded. All other patients were consecutively randomised into 3 groups which were given either trimethoprim + sulphamethoxazole or mecillinam (Group A), methenamine hippurate (Group B), or no treatment at all (Group C). Evaluation with respect to clinical signs of infection was done immediately after the treatment and 4 weeks later. In addition, a urine culture was performed 2 weeks after ESWL, i.e. 1 week after completing treatment with antibiotics and methenamine hippurate. With respect to infectious complications there were no differences between Groups A and C, between Groups B and C or between Group A and B+C, whereas an unexplained slightly higher infectious rate was recorded for Group B compared with Group A. In all patients the occurrence of bacteriuria was low (6.7%) despite the fact that almost 30% of patients had a ureteric catheter during the ESWL procedure. Patients with ureteric catheters did not present with more infectious complications than those without. All patients had a bladder catheter during ESWL. It was concluded that prophylactic treatment with antibiotics during ESWL treatment is unnecessary in all situations where an infectious aetiology is unlikely.

Topics: Adult; Amdinocillin; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Bacteriuria; Clinical Trials as Topic; Drug Combinations; Female; Hippurates; Humans; Lithotripsy; Male; Methenamine; Middle Aged; Premedication; Random Allocation; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Calculi; Urinary Catheterization

The treatment of two cases of toxic epidermal necrolysis (Lyell's syndrome) is described. Although some features were common for both ones (young men practically of the same age, reaction after using the same drug) the clinical course of illness was very different. Spontaneous epithelisation of partial-thickness lesions and definitive healing under the xenografts in one patient and full-thickness skin-loss on 12% of body surface with severe septic complications requiring application of cultured keratinocytes and/or skin autografting in the other patient were the main differences. The interdisciplinary approach using a burns treatment protocol in non-burned patient including the close co-operation with the tissue bank in preparing different types of biological covers has been applied.

Topics: Adolescent; Anti-Infective Agents; Histamine H1 Antagonists; Histamine H2 Antagonists; Humans; Immunization, Passive; Male; Skin Transplantation; Stevens-Johnson Syndrome; Transplantation, Heterologous; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Calculi

The authors describe rare types of drug-induced urolithiasis in two female patients (N4-acetylsulfamethoxazole--a Biseptol metabolite and oxolinic acid--Desurol). To improve the diagnosis of drug induced urolithiasis the authors recommend a combination of microscopic methods and infrared spectroscopy. They findings are documented by photographs and infrared absorption spectra.

Topics: Adult; Female; Humans; Oxolinic Acid; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Calculi