Untreated asymptomatic bacteriuria in girls: II--Effect of phenoxymethylpenicillin and erythromycin given for intercurrent infections.
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).
Hansson
S
S
Department of Paediatrics, Gothenburg University, East Hospital, Sweden.
Jodal
U
U
Lincoln
K
K
Svanborg-Edén
C
C
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
D004917:Erythromycin; D010404:Penicillin V