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. 1989 Apr 1;298(6677):856–859. doi: 10.1136/bmj.298.6677.856

Untreated asymptomatic bacteriuria in girls: II--Effect of phenoxymethylpenicillin and erythromycin given for intercurrent infections.

S Hansson 1, U Jodal 1, K Lincoln 1, C Svanborg-Edén 1
PMCID: PMC1836159  PMID: 2497823

Abstract

OBJECTIVE--To investigate the effects of phenoxymethylpenicillin and erythromycin on urinary isolates from patients with untreated asymptomatic bacteriuria. DESIGN--Retrospective study of subgroup of patients from cohort followed up till the end of 1986. SETTING--Outpatient clinic for children with urinary tract infections. PATIENTS--51 Girls aged under 15 with untreated asymptomatic bacteriuria. INTERVENTIONS--Before 1982 intercurrent infections (mostly tonsillitis or otitis) were treated with phenoxymethylpenicillin; after 1982 erythromycin treatment was preferred. END POINTS--Change of bacterial strain in urinary tract and symptomatic recurrences of disease. MEASUREMENTS AND MAIN RESULTS--Bacteria identified by serotype and electrophoretic type and compared before and after antibiotic treatment. Bacteriuria eradicated and replaced by new strains in most patients treated with phenoxymethylpenicillin, leading to symptomatic recurrences in about 15%. Conversely, patients given erythromycin rarely showed change in bacteriuria and none suffered symptomatic recurrence. CONCLUSIONS--In girls with untreated asymptomatic bacteriuria the use of phenoxymethylpenicillin for intercurrent infections may lead to a change of urinary bacteria and leave them at substantial risk of acute pyelonephritis. With erythromycin this risk is small (2/20 courses in this series).

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Selected References

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  1. Caugant D. A., Levin B. R., Orskov I., Orskov F., Svanborg Eden C., Selander R. K. Genetic diversity in relation to serotype in Escherichia coli. Infect Immun. 1985 Aug;49(2):407–413. doi: 10.1128/iai.49.2.407-413.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Heimdahl A., Nord C. E. Effect of phenoxymethylpenicillin and clindamycin on the oral, throat and faecal microflora of man. Scand J Infect Dis. 1979;11(3):233–242. doi: 10.3109/inf.1979.11.issue-3.11. [DOI] [PubMed] [Google Scholar]
  3. Jodal U., Lindberg U., Lincoln K. Level diagnosis of symptomatic urinary tract infections in childhood. Acta Paediatr Scand. 1975 Mar;64(2):201–208. doi: 10.1111/j.1651-2227.1975.tb03822.x. [DOI] [PubMed] [Google Scholar]
  4. Jodal U. The natural history of bacteriuria in childhood. Infect Dis Clin North Am. 1987 Dec;1(4):713–729. [PubMed] [Google Scholar]
  5. Lidin-Janson G., Falsen E., Jodal U., Kaijser B., Lincoln K. Characteristics of antibiotic-resistant Escherichia coli in the rectum of healthy school-children. J Med Microbiol. 1977 Aug;10(3):299–308. doi: 10.1099/00222615-10-3-299. [DOI] [PubMed] [Google Scholar]
  6. Lindberg U., Claesson I., Hanson L. A., Jodal U. Asymptomatic bacteriuria in schoolgirls. VIII. Clinical course during a 3-year follow-up. J Pediatr. 1978 Feb;92(2):194–199. doi: 10.1016/s0022-3476(78)80003-1. [DOI] [PubMed] [Google Scholar]
  7. Savage D. C., Howie G., Adler K., Wilson M. I. Controlled trial of therapy in covert bacteriuria of childhood. Lancet. 1975 Feb 15;1(7903):358–361. doi: 10.1016/s0140-6736(75)91277-5. [DOI] [PubMed] [Google Scholar]
  8. Zinner S. H., Sabath L. D., Casey J. I., Finland M. Erythromycin and alkalinisation of urine in the treatment of urinary-tract infections due to gram-negative bacilli. Lancet. 1971 Jun 19;1(7712):1267–1268. doi: 10.1016/s0140-6736(71)91780-6. [DOI] [PubMed] [Google Scholar]

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