Prevention of catheter-associated gram-negative bacilluria with norfloxacin by selective decontamination of the bowel and high urinary concentration.
Oral norfloxacin prevented Gram-negative bacilluria in female patients with hip fractures, who needed medium-term transurethral catheterization. This was shown in a placebo-controlled double-blind study of 34 patients. Seventeen of these received a suspension containing 200 mg norfloxacin and 500 mg amphotericin B, twice daily. In the placebo group, six cases of Gram-negative bacilluria had occurred by day 7, as compared with no cases during a median time of catheterization of 23 days in the group on medication. Bacteriuria, either by Gram-positive cocci or by Gram-negative bacilli, was observed in 50% of patients on placebo by day 7; in the treatment group this was the case by day 17 (P less than 0.001). Subsequent bacteriuria with Gram-positive cocci was eliminated by nitrofurantoin (50 mg qid) within four days. Norfloxacin is very suitable for the prevention of Gram-negative bacilluria, because it decontaminates Gram-negative bacilli from the bowel, reaches high concentrations in urine and rarely produces resistant variants.
Vollaard
E J
EJ
Department of Pharmacy, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Clasener
H A
HA
Zambon
J V
JV
Joosten
H J
HJ
van Griethuysen
A J
AJ
D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D001437:Bacteriuria / Q000517:prevention & control*; D002176:Candida albicans; D004064:Digestive System / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006090:Gram-Negative Bacteria; D006620:Hip Fractures / Q000150:complications / Q000382:microbiology; D006801:Humans; D009643:Norfloxacin / Q000627:therapeutic use* / Q000652:urine; D014546:Urinary Catheterization / Q000009:adverse effects*
D000666:Amphotericin B; D009643:Norfloxacin