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Intravesical gentamicin instillation cuts number of UTI episodes

6 days ago

Intravesical instillation of gentamicin appears to result in reduced number of urinary tract infection (UTI) episodes and degree of antimicrobial resistance, a study has shown.

The study included 63 adults with recurrent UTI caused by multidrug-resistant (MDR) pathogens. All of them received overnight intravesical gentamicin instillations for 6 months.

Recurrence rate of UTIs, the primary study outcome, dropped from 4.8 at baseline to 1.0 during intravesical treatment. The secondary outcome of resistance to uropathogens also improved, with the rate falling from 78 percent to 23 percent.

In terms of safety, there were no reports of systemic absorption or clinically relevant side effects.

Intravesical instillations have long been used in urology, mostly for treating nonmuscle invasive bladder cancer. Gentamicin is believed to be an ideal antibiotic for intravesical instillation, having been shown to be bactericidal against most gram-negative genitourinary pathogens including some multiresistant organisms. Intravenous use of this drug is limited by potential nephrotoxic and ototoxic effects, although the bladder provides an impermeable surface and allows the drug to be concentrated at high levels in the target area. Another advantage of not administering it systemically is the avoidance of side effects such as nausea, diarrhoea and colonic superinfection. [Int J Antimicrob Agents 2010;36:485-490]

Recurrent UTIs are a common problem, negatively affecting quality of life and possibly requiring hospital admission. About one-third of females will have a UTI in their lifetime, with evidence showing that 24–50 percent of them will have a recurrence within 6 months of the index infection. [Neurourol Urodyn 2017;36:2109-2116]

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Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Jairia Dela Cruz, 26 Jun 2018
The monoclonal antibody denosumab is safe and effective for use in patients on glucocorticoids and at risk of developing fractures, with a recent study showing that the drug performs better than risedronate in increasing bone mineral density (BMD).
Pearl Toh, 20 Mar 2018
Not only does treatment with the PCSK9* inhibitor alirocumab reduces cardiovascular (CV) events along with plunges in LDL-C levels, it was also associated with a reduced risk of all-cause mortality compared with placebo in patient with a recent acute coronary syndrome (ACS) and persistently high cholesterol despite maximal statin therapy, according to top-line results from the ODYSSEY** Outcomes trial.