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[Urinary tract infection associated with urinary calculi. 2. Effects of antibiotics on bacteria within infected
H Takeuchi1, Y Okada, O Yoshida
1Department of Urology, Faculty of Medicine, Kyoto University.
Abstract:
We investigated the effect of antimicrobial agents against bacteria within infected stones. Cefmetazole (CMZ) was found to have equally strong activities against gram-positive and gram-negative bacteria isolated from the stones. In addition, CMZ was excreted in the urine from the affected kidney in high concentrations and was penetrated into the stone to some extent in vitro. However, preoperative administration of CMZ did not so significantly eradicate bacteria within the stones. Stones may function as a sanctuary for organisms and may attenuate the effects of antibiotics against them. Therefore, to treat urinary tract infection associated with urinary calculi, complete extirpation is necessary. In recent years, ultrasonic and other types of stone crushing methods are in wide use. CMZ or other effective antibiotics may become useful for the perioperative management of infected urinary stones.
Insights
Cefmetazole (CMZ) effectively targets bacteria in urinary stones, but doesn't fully eradicate them. Complete stone removal is crucial for treating infected urinary tract infections.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Context:
- Urinary tract infections (UTIs) associated with urinary calculi pose a significant clinical challenge.
- Bacteria residing within infected stones are often protected from antibiotic treatment.
Purpose:
- To investigate the efficacy of antimicrobial agents, specifically Cefmetazole (CMZ), against bacteria within infected urinary stones.
- To evaluate the potential of CMZ for treating UTIs linked to urinary calculi.
Summary:
- Cefmetazole (CMZ) demonstrated potent in vitro activity against both gram-positive and gram-negative bacteria isolated from urinary stones.
- While CMZ achieved high urinary and moderate in vitro stone penetration, preoperative administration did not significantly eradicate bacteria within the stones.
- Urinary stones act as a sanctuary, potentially attenuating antibiotic effects.
Impact:
- Complete surgical extirpation of infected urinary stones is essential for effective treatment.
- Effective antibiotics like CMZ may play a role in perioperative management, especially with the rise of stone-crushing techniques.