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.
AuthorsE J Vollaard, H A Clasener, J V Zambon, H J Joosten, A J van Griethuysen
JournalThe Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 23 Issue 6 Pg. 915-22 (Jun 1989) ISSN: 0305-7453 [Print] ENGLAND
PMID2668253 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Amphotericin B
  • Norfloxacin
  • Aged
  • Aged, 80 and over
  • Amphotericin B (therapeutic use)
  • Bacteriuria (prevention & control)
  • Candida albicans
  • Digestive System (microbiology)
  • Feces (microbiology)
  • Female
  • Gram-Negative Bacteria
  • Hip Fractures (complications, microbiology)
  • Humans
  • Norfloxacin (therapeutic use, urine)
  • Urinary Catheterization (adverse effects)

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