- •1. Introduction
- •1.1 Classification
- •1.2 References
- •2.2 Background
- •2.3 Definition
- •2.4 Aetiological spectrum
- •2.5 Acute uncomplicated cystitis in pre-menopausal, non-pregnant women
- •2.8 UtIs in pregnancy
- •2.9 UtIs in post-menopausal women
- •2.11 References
- •19. Roberts fj.
- •27. Sanford jp.
- •28. Kinane df, Blackwell cc, Brettle rp, Weir dm, Winstanley fp, Eltor ra.
- •32. Nicolle le, Harding gkm, Preiksaitis j, Ronald ar.
- •50. Wadland wc, Planten da.
- •60. Vorland lh, Carlson k, Aalen odd.
- •3.2 Background
- •3.3 Aetiology
- •3.4 Pathogenesis
- •3.5 Signs and symptoms
- •3.7 Schedule of investigation
- •If findings indicate pathology
- •3.9 References
- •21. Jantausch pa, Rifai n, Getson p, Akrem s, Majd m, Wiedermann bl.
- •32. Rushton hg, Majd m, Jantausch b, Wiedermann l, Belman ab.
- •43. Kleinman pk, Diamond ba, Karellas a, Spevak mr, Nimkin k, Belenguer p.
- •4.2 Background
- •4.3 What are the acute effects of a uti on the kidney and do the lesions become chronic? Can they be prevented?
- •4.7 References
- •5.2 Definitions and classification
- •5.4 Treatment
- •5.5 Conclusions
- •5.6 References
- •6.2 Background
- •6.3 Definition and clinical manifestation of sepsis syndrome in urology
- •6.4 Physiology and biochemical markers
- •6.5 Prevention
- •6.6 Treatment of underlying disease
- •6.7 Conclusion
- •6.8 References
- •7.7 Therapy
- •7.8 Prevention
- •8.2 Prostatitis
- •8.3 Epididymitis and orchitis
- •8.4 References
- •1. Meares em, Stamey та.
- •2. Weidner w, Schiefer hg, Krauss h, Jantos Ch, Friedrich hj, Altmannsberger m.
- •3. Schaeffer aj.
- •8. Alexander rb, Ponniah s, Hasday j, Hebel jr.
- •26. Barbalias ga, Nikiforidis g, Liatsikos en.
- •27. Mayersak js.
- •28. Jimenez Cruz jf, Boronat f, Gallego j.
- •33. Naber kg, Weidner w.
- •9. Peri-operative antibacterial prophylaxis in urology
- •9.1 Summary
- •9.2 Introduction
- •9.3 Goals of peri-operative antibacterial prophylaxis
- •9.4 Indications for peri-operative antibacterial prophylaxis
- •9.5 Timing and duration of peri-operative antibacterial prophylaxis
- •9.6 Choice of antibiotics
- •9.7 Mode of application
- •9.8 Recommendations according to type of urological intervention
- •9.10 References
- •1. Rubin rh, Shapiro ed, Andriol vt, Davies rj, Stamm we.
- •3. Naber kg.
- •3. Recommendations for peri-operative antibacterial prophylaxis in urology (modified according to ref 1)
- •4. Antibacterial agents
- •4.1 Penicillins
- •4.2 Parenteral cephalosporins
- •4.3 Oral cephalosporins
- •4.4 Monobactams
- •4.5 Carbapenems
- •4.6 Fluoroquinolones
- •4.7 Macrolides
- •4.8 Tetracyclines
- •4.9 Aminoglycosides
- •4.10 Glycopeptides
- •4.11 References
4.2 Parenteral cephalosporins
According to the Paul Ehrlich Society for Chemotherapy (1), the parenteral cephalosporins have been classified into five groups, according to their spectrum of activity (Table 19).
Group 1 cephalosporins (cefazolin, cefazedone) are very active against streptococci and staphylococci (penicillin G-resistant strains included). They have only weak activity against Gram-negative microorganisms. Like all cephalosporins, cefazolin is not active against enterococci and MRSA and methicillin-resistant coagulase-negative staphylococci (MRSE).
Compared with Group 1 cephalosporins, Group 2 cephalosporins, e.g. cefuroxime, cefotiame and cefamandole, exhibit a markedly improved activity against Gram-negative pathogens and maintain high activity against staphylococci.
Group 3a cephalosporins have high activity against Gram-negatives and less activity against staphylococci. They differ mainly in their pharmacokinetic characteristics.
Group 3b cephalosporins, e.g. ceftazidime, cefepime, cefoperazone and cefpirome, have added high anti-Pseudomonas activity. However, the activity of cefoperazone against P. aeruginosa is markedly inferior to that of the other substances of this group.
Cefsulodine has a special position among Group 4 cephalosporins with its therapeutic relevance limited to P. aeruginosa.
The Group 5 cephalosporins are characterized by their anti-anaerobic activity. These cephalosporins have superior activity against Gram-negative bacteria compared with Group 1 and 2 cephalosporins, but most of them are weaker than Group 3 drugs. At present, cefoxitin is the only drug of that group available on the market in some countries.
Table 20: Classification of parenteral cephalosporins according to the Paul Ehrlich Society for Chemotherapy (2)
|
|
Generic names |
Features of the group |
|
Group 1 |
Cefazolin |
• Active against Gram-positive and partly also against Gram- |
|
(1st generation) |
Cefazedone |
negative bacteria |
|
|
|
•Stable against staphylococcal penicillinases |
|
|
|
• Unstable against (3-lactamases of Gram-negative bacteria |
|
Group 2 |
Cefuroxime |
•Activity against Gram-positive bacteria good, but weaker |
|
(2nd generation) |
Cefotiame |
than Group 1 |
|
|
Cefamandole |
•Activity against Gram-negative bacteria superior to that of Group 1 |
|
|
|
• Stable against staphylococcal penicillinases |
|
|
|
• Limited stability against p-lactamases of Gram-negative bacteria |
|
Group 3a |
Cefotaxime |
•Activity against Gram-negative bacteria clearly superior to that |
|
(3rd generation) |
Ceftriaxone |
of Groups 1 and 2 |
|
|
Ceftizoxime |
• Stable against numerous p-lactamases of Gram-negative bacteria |
|
|
Cefmenoxime |
• Microbiologically less active against staphylococci |
|
|
Cefodizime |
|
|
Group 3b |
Ceftazidime |
• Spectrum of antibacterial activity similar to that of Group 3a |
|
(3rd generation) |
Cefepime |
•Additional activity against Pseudomonas aeruginosa |
|
|
Cefpirome |
|
|
|
Cefoperazone |
|
|
Group 4 |
Cefsulodin |
• Narrow antibacterial spectrum |
|
|
|
• Only activity against P. aeruginosa relevant therapeutically |
|
Group 5 |
Cefoxitin* |
•Active against anaerobe bacteria |
|
(*2nd and °3rd |
Cefotetan0 |
• Activity against Gram-negative bacteria superior to that of |
|
generation) |
Flomoxef |
Group 2, but inferior to that of Group 3a/b |
|
|
|
• Activity against staphylococci unsatisfactory |