Category Urinary tract infections
Non-pharmacological prevention of UTI for older people: what is the evidence base?
Guest posting: Dr Penny Webster, Staff Specialist Geriatric Medicine, Hunter New England Health Hydration Increasing fluid intake (by 1.5 litres per day) was shown in an RCT to reduce the incidence of urinary infections in premenopausal women (Hooton et al 2018 JAMA Int Med). The effect size was considerable – during the 12-months, the mean […]
Which patients benefit from Asymptomatic Bacteriuria screening?
Guest posting Dr Victoria Jordan, Microbiology & Infectious Diseases Registrar, Pathology NSW. What is asymptomatic bacteriuria (ASB)? This is the presence of significant bacterial growth ((≥105 colony-forming units [CFU]/mL) in the urine in the absence of urinary symptoms. It likely occurs via ascension from perineal flora. Commoner with aging: prevalence 5% in healthy premenopausal women; […]
“UTI” – Requiem for a Heavyweight – a landmark paper
A recent paper, “Urinary Tract Infection”-Requiem for a Heavyweight by Dr Thomas Finucaine skillfully unpacks many key issues, coupling this with a consideration of the emerging knowledge of the urinary microbiome and virome, suggesting that the term “UTI” might better be referred to as a “urinary dysbiosis”. The paper is worth a detailed read – here […]
The old antibiotics are still useful – Fosfomycin
The Special Access Scheme (SAS) allows practitioners to import/gain access to therapeutic goods currently not registered on the Australian Register of Therapeutic Goods (ARTG) for a single patient on a case by case basis. Fosfomycin (one such SAS drug) is a broad spectrum antibiotic belonging to the phosphonic acid derivative drug class (other examples in this drug class include foscarnet and adefovir).
Ciprofloxacin and other fluoroquinolones: should you think twice about prescribing?
Fluoroquinolones (ciprofloxacin, moxifloxacin and norfloxacin) (FQ) are essential agents for directed treatment of certain types of resistant aerobic Gram negative bacterial species where FQ susceptibility has been proven. They are best avoided as empirical therapy or where there is an alternative due to these potential serious side effects:
Cranberry for prevention and treatment of UTI- placebo or better?
Updated 25/1/24: Cochrane review was updated in Dec 2023 . “Authors’ conclusions: After a thorough search, no RCTs which assessed the effectiveness of cranberry juice for the treatment of UTIs were found. Therefore, at the present time, there is no good quality evidence to suggest that it is effective for the treatment of UTIs. ” Cranberry […]
Antimicrobial prophylaxis, quinolone resistance and prostate biopsy safety
Guest post: Patrick Harris, Staff Specialist in Microbiology, Central Laboratory, Pathology Queensland, Brisbane Overseas travel and prostate biopsies: a key risk-factor for infectious complications with multi-drug resistant bacteria Given an ageing population and the current reliance upon PSA testing to screen for prostate cancer, patients are increasingly being referred for trans-rectal ultrasound (TRUS)-guided prostate biopsies. Millions […]
Recurrent urinary tract infection in women – are antibiotics the answer?
What is the evidence? This interesting paper from 2010 discusses the natural history of UTI in women and distinguishes two conditions – the ‘urethral’ (or ‘dysuria/frequency’) syndrome’ (US) which affects a proportion of women with recurrent symptoms and many courses of treatment. It is known that US is a self-limited condition in a majority of patients. Some women are said to […]
Case report: Community-Acquired Pyelonephritis in Pregnancy Caused by KPC-Producing Klebsiella pneumoniae
In northern NSW, we already face cases similar to that described below – infection with multi-drug resistant carbapenemase-producing Gram negative organisms. The major global types of these organisms are named with acronyms that refer to the type of carbapenemase gene – KPC, NDM (New Delhi Metallobetalactamase), IMP (imipenemase) and others. KPC-type organisms are prevalent in Greece, […]
AIMED - Let's talk about antibiotics 
Micro lab comments: candidaemia and candiduria
Candidal bloodstream infection represents a high risk infection, even for immunocompetent patients. Mortality is significant even for IV line-associated candidaemia. Blood cultures are seldom contaminated by fungi and any patient with an isolate must be subjected to careful clinical assessment. Our comment serves to give a few reminders that follow on from the liaison between the […]