Insights into the pathogenesis of
urinary tract infections warrant reflections on new therapeutic strategies. Of particular interest is the phenomenon of bacterial adherence to cells, as the adhesion of microorganisms to uroepithelial cells plays an important role in the development of the disease. In 21 women with an acute episode of lower
urinary tract infection who were known of having chronic
pyelonephritis, we studied the influence of a one-day (n = 7) and a seven-day treatment by administering the regular
sulfamerazine/trimethoprime (
Berlocombin) dose (2 X 2
tablets from the 2nd day, n = 7) or a reduced amount (2 X 1
tablet from the 2nd day, n = 7). All treatment regimes led to a disappearance of the clinical symptoms; however, in one case of the group receiving one-day treatment, dysuric complaints recurred as early as on day 3 after
therapy. Only when employing the regular schedule of
therapy, the controls of the urine cultures revealed
sterility of the urine for all cases still on the 21st day
after treatment. This treatment regimen most clearly influenced the ability of the microorganisms to adhere to the uroepithelial cells of the probands (in-vivo adherence). The one-day treatment was not able to reduce the rates of bacterial adherence to the cells. In all patients, the
acute disease resulted in an increase in microorganisms coated with
antibodies; on day 21 following
therapy, however, the findings registered were as before onset of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)