Erythromycin for persistent or recurrent nongonococcal urethritis

Article Abstract:

Nongonococcal urethritis is a condition characterized by inflammation of the urethra, which conveys urine from the bladder to the outside of the body. The most common bacteria responsible for this condition are Chlamydia trachomatis and Ureaplasma urealyticum, but in almost 30 percent of the cases, the responsible organism is not known. From 70 to 80 percent of the men infected with the above bacteria respond to antibiotic therapy. Those men infected with neither bacteria who are given antibiotic therapy with tetracycline or erythromycin have a recurrence rate as high as 50 percent. This may be attributable to antibiotic-resistant bacteria. Patients who do not respond to tetracycline therapy are often put on erythromycin therapy, but to date, the effectiveness of this strategy has not been examined. This study assessed the effectiveness of erythromycin in 77 men with recurrent or persistent nongonococcal urethritis, some of which had failed to improve with prior antibiotic therapy. Patients received 500 mg of erythromycin four times a day for three weeks. Two weeks after therapy began, 13 of 25 erythromycin-treated patients had resolution of their infection as compared with 8 of 34 patients receiving a sugar pill (placebo). Erythromycin therapy also decreased the amount of pus in the urine by 89 percent compared with a 23 percent decrease for those patients on a placebo. Additionally, in men with inflammation of the prostate gland, erythromycin decreased the amount of pus in the urine by 94 percent, as compared with a 46 percent increase in patients taking a placebo. This study indicates that three weeks of treatment with erythromycin for nongonococcal urethritis is very effective in relieving symptoms and reducing the amount of pus in the urine, especially in men with inflammation of the prostate gland. (Consumer Summary produced by Reliance Medical Information, Inc.)

Erythromycin

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Ciprofloxacin compared with doxycycline for nongonococcal urethritis: ineffectiveness against Chlamydia trachomatis due to relapsing infection

Article Abstract:

Inflammation of the male urethra, the duct that conducts urine from the bladder through the prostate and penis, is called urethritis. Urethritis that is not caused by gonorrhea, nongonococcal urethritis, is the most frequent form of sexually transmitted disease in male Americans. Most cases are caused either by the bacteria Chlamydia trachomatis (30 to 50 percent) or by Ureaplasma urealyticum (up to 40 percent). In a significant number of additional cases, a pathogenic organism is suspected but not isolated. Although the antibiotics tetracycline and erythromycin are effective against Chlamydia and Ureaplasma, some strains of these organisms have developed resistance to the drug and alternative drug therapy regimens are required in perhaps 30 percent of cases of persistent or recurrent urethritis. Before a new drug is recommended as a first-line of defense, its effectiveness must be at least as great as the current drugs against chlamydial infection. A group of 178 men seen at a sexually transmitted disease clinic were enrolled in a double-blind study to examine the effectiveness of various dose levels of ciprofloxacin and doxycycline to alleviate nongonococcal infections. The general responses of the three treatment groups were statistically similar. However, men with an original culture of Chlamydia who were treated with ciprofloxacin had a high rate of recurrence of Chlamydia within four weeks of treatment; none of the patients treated with doxycycline exhibited regrowth of Chlamydia. Ciprofloxacin at the dosages used in this study was not effective in the treatment of chlamydial urethritis in men. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexually transmitted diseases, Chlamydia infections, Tetracyclines, Ureaplasma urealyticum, Ciprofloxacin

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Escherichia coli bacteriuria and contraceptive method

Article Abstract:

Sexual intercourse and the use of a diaphragm increase the risk of urinary tract infections in young women. The combined use of a diaphragm and spermicide may cause one third of more than 5 million cases of urinary tract infection each year in the US. The effects of sexual intercourse and different methods of contraception on the development of bacteriuria (the presence of bacteria in the urine) and on the growth of the bacteria Escherichia coli (E. coli) in the vagina, were assessed in 104 women. The women were examined before sexual intercourse, the morning after intercourse, and again 24 hours later. E. coli-related bacteriuria was more prevalent after intercourse among foam-condom and diaphragm-spermicide users than women using oral contraceptives. The prevalence of E. coli bacteriuria remained elevated 24 hours later in women using foam-condom or diaphragm-spermicide contraception. The growth of E.coli in the vagina was also greater and more persistent in foam-condoms and diaphragm-spermicide users compared with women using oral contraception. The growth of other types of microorganisms in the vagina, including Candida, enterococci and staphylococci, was increased among diaphragm-spermicide users after intercourse. These findings suggest that the combined use of a diaphragm and spermicidal jelly, or condom and spermicidal foam, alters the normal flora of the vagina, leading to an increased risk for bacterial growth and E. coli-related bacteriuria. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Causes of, Complications and side effects, Physiological aspects, Contraception, Vagina, Escherichia coli infections, Bacteria in the urine, Bacteriuria

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