Combined effect of clarithromycin and imipenem/cilastatin against urinary biofilm infection after pyeloplasty.
The present report concerns a 38-year-old man, who had been treated with pyeloplasty and lithotomy for the improvement of urinary excretion and resolution of a kidney stone. The patient developed a biofilm infection involving Pseudomonas aeruginosa and Staphylococcus epidermidis, and had been suffering from recurrent acute pyelonephritis for one year. Combination therapy with clarithromycin (CAM) and imipenem/cilastatin (IMP/CS) consisted of administration of CAM at a dose of 400 mg/day for 1 week, followed by 500 mg/day of IMP by intravenous infusion combined with CAM (400 mg/day) for 5 days. This therapy produced an immediate antimicrobial effect and no further signs of pyuria have been seen during one year of follow-up in this patient.
Furuhata
Masayuki
M
Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan. furufuru@kk.iij4u.or.jp
Iwamura
Masatsugu
M
Baba
Shiro
S
Inoue
Matsuhisa
M
D000328:Adult; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development; D015377:Cilastatin / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007669:Kidney Calculi / Q000150:complications / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D011704:Pyelonephritis / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000150:complications / Q000601:surgery
D015377:Cilastatin; D015378:Imipenem; D017291:Clarithromycin