zithromax and Bacteriuria

We assessed the correlation between ligase chain reaction (LCR) on first void urine (FVU) and cultures of urethral and cervical swabs to detect chlamydia during three post-treatment follow up visits for 10 men and 19 women with genital chlamydial infections who had been treated with azithromycin or doxcycline.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Bacteriuria; Chlamydia Infections; Doxycycline; Female; Follow-Up Studies; Humans; Ligase Chain Reaction; Male; Reagent Kits, Diagnostic; Recurrence; Sensitivity and Specificity; Specimen Handling

OBJECTIVES. To determine the incidence of Ureaplasma urealyticum in women experiencing chronic urinary symptoms and to determine whether antibiotic therapy targeting these organisms is effective.. Forty-eight consecutive women referred to our academic medical center for chronic voiding symptoms and possible interstitial cystitis underwent urologic evaluation, including culture screening for U. urealyticum and Mycoplasma hominis. Patients with positive cultures were treated with a 1-g dose of azithromycin; persistent infection was treated with 7 days of doxycycline, ofloxacin, or erythromycin. Patients reported symptom severity (0, mild; 3, severe) and voiding frequency before and 6 months after treatment.. Positive cultures were obtained in 23 (48%) of 48 patients; 22 had U. urealyticum and 1 had M. hominis. All had negative cultures after treatment. The mean symptom severity score improved with treatment (2.2 to 0.7, P <0.001), and the mean urinary frequency decreased (9.2 daily to 6.8 daily, P <0.001). Two of the 23 patients experienced no improvement; one had detrusor instability and the other had medically related urinary frequency. Of the 25 patients with negative cultures, interstitial cystitis was established in only 9 (19% of the total sample).. Although often overlooked or improperly treated, U. urealyticum and M. hominis infections may account for a large proportion of unexplained chronic voiding symptoms. Culture and treatment should be considered before pursuing more costly and invasive tests.

Topics: Adolescent; Adult; Aged; Azithromycin; Bacteriological Techniques; Bacteriuria; Chronic Disease; Cystitis, Interstitial; Doxycycline; Erythromycin; Female; Humans; Middle Aged; Ofloxacin; Treatment Outcome; Ureaplasma Infections; Ureaplasma urealyticum; Urination Disorders