URINARY TRACT ANTISEPTICS

UTI - common in the elderly and in young women

the most common pathogen - E.coli, Klebsiella pneumoniae, Proteus mirabilis

Treatment:

Sulfonamides: sulfizoxasole

co-trimoxasole

Antibiotics: amoxycillin

tetracyclins

drugs concentrated in urine: methenamine - for chronic suppressive therapy

decomposes to formaldehyde and ammonia

(contraindicated in hepatic insufficiency)

(urea-splitting bacteria attenuate the activity, eg. Proteus)

not decomposed systemically (pH - 7.4)

side effects: GI distress

albuminuria, hematuria, rashes

sulfonamides react with formaldehyde - do not combine

nalidixic acid

nitrotrofurantoin - bacteriostatic

narrow spectrum - E.coli, G+ cocci (the rest - resistant)

toxic

no resistance during therapy

side effects: GI distress (diary products help)

acute pneumonitis

headache

nystagmus

polyneuropthathies

hemolytic anemia in pregnant women, neonates and defficient in G-6-DHG

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