Factors Determining the Outcome of Chemotherapy in Infections of the Urinary Tract

Abstract

Patients with infections of the urinary tract were divided into 4 categories. Those with uncomplicated acute pyelonephritis made a good response to therapy. Those with complicated acute pyelonephritis responded to antimicrobials following correction of obstruction. Chronic bacteriuria was caused by E. coli; although Klebsiella- Aerobacter, Paracolon and Proteus mirabilis were often isolated. These species were more resistant to antibiotics than those cultured from patients with acute uncomplicated disease. Bacteriuria was eliminated in most patients, during therapy, but recurrence with the initial pathogen or appearance of a new organism was the rule after therapy was completed. In some patients organisms were not eliminated during treatment. This was usually related to poor gastrointestinal absorption of a drug or emergence of resistant mutants. Those with asymptomatic bacteriuria of unknown duration responded to treatment in a manner similar to those of the group with chronic bacteriuria. Classification of patients with urinary tract infection is helpful in estimating prognosis and outcome of therapy.