title: Untreated asymptomatic bacteriuria in girls: II--Effect of phenoxymethylpenicillin and erythromycin given for intercurrent infections.
abstract: OBJECTIVE
  To investigate the effects of phenoxymethylpenicillin and erythromycin on urinary isolates from patients with untreated asymptomatic bacteriuria.
  
  
  METHODS
  Retrospective study of subgroup of patients from cohort followed up till the end of 1986.
  
  
  METHODS
  Outpatient clinic for children with urinary tract infections.
  
  
  METHODS
  51 Girls aged under 15 with untreated asymptomatic bacteriuria.
  
  
  METHODS
  Before 1982 intercurrent infections (mostly tonsillitis or otitis) were treated with phenoxymethylpenicillin; after 1982 erythromycin treatment was preferred.
  
  
  METHODS
  Change of bacterial strain in urinary tract and symptomatic recurrences of disease.
  
  
  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).
authors.affiliation: Department of Paediatrics, Gothenburg University, East Hospital, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Hansson
authors.forename: U
authors.initials: U
authors.lastname: Jodal
authors.forename: K
authors.initials: K
authors.lastname: Lincoln
authors.forename: C
authors.initials: C
authors.lastname: Svanborg-Edén
mesh_terms: D000293:Adolescent; D001437:Bacteriuria / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004352:Drug Resistance, Microbial; D004592:Electrophoresis, Starch Gel; D004917:Erythromycin / Q000627:therapeutic use*; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D005260:Female; D006801:Humans; D010033:Otitis Media / Q000150:complications / Q000188:drug therapy; D010404:Penicillin V / Q000627:therapeutic use*; D012189:Retrospective Studies; D012703:Serotyping; D014069:Tonsillitis / Q000150:complications / Q000188:drug therapy
chemical_list: D004917:Erythromycin; D010404:Penicillin V