Urinary tract infections in patients with severe renal disease. Treatment with ampicillin and trimethoprim-sulfamethoxazole
W. M. Bennett and R. Craven
Twelve patients with severe renal failure and intercurrent urinary tract
infections were treated with either ampicillin trihydrate, 500 mg four
times a day, or trimethoprim-sulfamethoxazole, two tablets (80 mg
trimethoprim, 400 mg sulfamethoxazole) twice a day. All patients achieved
bacteriologic cure, including six with proved upper tract infection. Serum
levels of all drugs were increased to values above those seen in normal
subjects without adverse effects. Urine concentrations of trimethoprim,
28.6 mug/ml, and ampicillin, 88.6 mug/ml, were well above the minimum
inhibitory concentrations of urinary pathogens. Urine sulfamethoxazole
concentrations were less than 10 mug/ml in four of the six patients
treated; however, this did not hamper bacteriologic success. It is
concluded that both drugs can be used to treat urinary tract infections in
patients with renal functional impairment.
