Catheter-associated urinary tract infections: epidemiology. pathogenesis, and prevention

Article Abstract:

Urinary tract infections (UTIs) caused by catheters (tubes inserted into the urethra and bladder for the removal of urine) are the most common type of infection acquired during hospitalization. In most cases the infection is not serious. However, UTIs have been reported to cause life-threatening bacteremia (bacteria in the blood) in 2 to 4 percent of infected patients. Factors that increase the risk of developing UTIs include long-term use of a catheter, being female, lack of treatment with antibiotics, and a disconnection at the junction of the catheter and collecting tube. Women have a greater risk of UTIs because the bacteria, usually from the rectum, can enter the body in the space between the catheter and opening of the urethra. Antibiotic creams can be applied around the opening of the urethra to reduce the risk of infection. In men, UTI is more likely to be caused by bacteria present inside of the urethra or catheter. Patients who require catheterization for long periods of time (greater than 30 days) are prime candidates for UTI, and in fact, bacteriuria (bacteria in the urine) occurs in almost 100 percent of these patients. When bacteria are present inside the catheter they stick to the sides of the tube and can eventually plug or block the tube completely (catheter encrustation and obstruction). This is a recurrent problem in patients with long-term catheters, and it is difficult to treat. Removing the catheter for short periods of time and treatment with antibiotics have been successful in treating some of these patients. Administering antibiotics during the first four to five days of catheterization has been shown to reduce UTI in patients who do not require catheterization for long periods of time. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Causes of, Complications and side effects, Urinary tract infections, Urinary catheterization

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Azithromycin compared with cephalexin in the treatment of skin and skin structure infections

Article Abstract:

This study was carried out to evaluate the effectiveness and safety of a newly developed antibiotic, azithromycin, for treating infections of the skin or skin structures (for instance, the connective tissue of the skin). One hundred forty-eight patients at 25 medical centers with abscesses, cellulitis (infection of the connective tissue), impetigo, infected wounds, or other infections were randomly assigned to receive either azithromycin (102 subjects) or cephalexin, a cephalosporin antibiotic, (46 subjects). Patients' clinical responses were determined by examination at baseline, and again on days 6, 11, 18, and 30 after treatment commencement. Bacteriologic eradication was defined as elimination of the causative organism by day 11 of the study. Results for the azithromycin group showed that clinical cures were effected after five days for 68 patients (67 percent), with 33 patients showing improvement. In the cephalexin group, 27 patients (59 percent) were cured after 10 days treatment, and 17 improved. The side effects of both drugs were mild and consisted of diarrhea, abdominal pain, and nausea. A five-day, once-daily course of azithromycin seems as effective as a 10-day, twice-daily course of cephalexin for managing skin and skin structure infections. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Skin diseases, Bacterial infections, Azithromycin, Cephalexin

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