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Synergistic effect of promethazine with gentamycin in frequently recurring pyelonephritis
J Molnár1, I Haszon, T Bodrogi
1Department of Microbiology, Szent-Györgyi Albert University Medical School, Szeged, Hungary.
Insights
Adding promethazine to gentamycin significantly reduced recurrent pyelonephritis in children. This combination therapy shows promise for eliminating recurring urinary tract infections by enhancing antibiotic sensitivity.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Recurrent pyelonephritis in children, even without urological abnormalities, poses a significant health challenge.
- Long-term antibiotic prophylaxis is a common but not always fully effective treatment strategy.
- The potential synergistic effects of adjunctive therapies require further investigation.
Purpose of the Study:
- To evaluate the efficacy of combining gentamycin with promethazine for treating recurrent pyelonephritis in children.
- To compare this combination therapy against gentamycin alone and long-term antibiotic prophylaxis.
- To assess the impact on recurrence rates and renal scarring.
Main Methods:
- A comparative study involving three groups of children with recurrent pyelonephritis.
- Group 1: Gentamycin and promethazine combination therapy (7 days).
- Group 2: Gentamycin alone (10 days). Group 3: Long-term oral antibiotic prophylaxis with intensive recurrence treatment.
- Follow-up period of 3 years to record pyelonephritis recurrences and renal scarring.
Main Results:
- The combination of gentamycin and promethazine (Group 1) resulted in significantly fewer pyelonephritis recurrences compared to gentamycin alone (Group 2) and long-term prophylaxis (Group 3).
- Six out of 19 children in the long-term prophylaxis group (Group 3) developed renal scarring.
- The study suggests a synergistic effect between gentamycin and promethazine.
Conclusions:
- Combination therapy with gentamycin and promethazine is a highly effective treatment for reducing recurrent pyelonephritis in children.
- Promethazine may enhance antibiotic sensitivity, aiding in the elimination of persistent urinary tract infections.
- This approach offers a promising alternative to long-term antibiotic prophylaxis, potentially reducing the risk of renal scarring.
Abstract:
The effects of promethazine were studied in children with frequently recurring pyelonephritis which was not associated with urological abnormalities. The results of three methods of treatment were compared: 10 children were given a combination of gentamycin and promethazine for 7 days (Group 1), 11 received gentamycin treatment alone for 10 days (Group 2), and 19 (Group 3) were on long-term oral antibiotic prophylaxis (5.6 +/- 2.1 years) with episodes of intensive treatment of recurrences. In a 3-year follow-up period, the number of pyelonephritis recurrences was significantly lower in Group 1 than in Groups 2 and 3. Six out of 19 children in Group 3 had renal scarring. The authors suggest a synergistic effect between gentamycin and promethazine therapy. Promethazine increases antibiotic sensitivity, which could contribute to the elimination of recurring urinary tract infections.