Common bacterial urinary tract infections in women.

Unfortunately, there is no general consensus as to how long patients with bacteriuria or urinary tract infections should be monitored and certainly there is no agreement on how long recurrent episodes should be treated beyond ten days to two weeks. The most important points to remember are: 1. Culture the urine both at the time of therapy and during follow-up. The patient should be examined periodically for the presence of bacteruria. If bacteria cannot be eradicated, at least the physician is aware of the organism most likely causing the patient's symptoms. 2. Do not subject the patient with frequent recurrent (chronic) and complicated infections to continual antibacterial therapy, but rather, manage the acute episodes. 3. Use prophylaxis, particularly single bed-time doses for dysuria and frequency symptoms. 4. Screen for bacteriuria during pregnancy. 5. Avoid the use of catheters except where absolutely necessary. 6. Avoid systemic prophylaxis of infection in patients with catheters; rather, use closed-system drainage with antibacteri-irrigation. It is to be hoped within the next few years, studies now underway will allow specific recommendations regarding the management of asymptomatic bacteruria, the duration of therapy for recurrent infections, the prevention and treatment of L-form bacterial infections, and indications for urologic procedures.

Hemodialysis properties of clindamycin (7-chloro-7-deoxylincomycin).

The effect of hemodialysis (Kolff-type machine) on clindamycin blood levels in anuric patients was studied. At 1 hr after oral ingestion of drug, blood levels ranged from 1.23 to 5.17 mug/ml and fell thereafter. Half-times for peripheral removal were 3.36 mug/ml +/- 0.22 when subjects were "off" dialysis and 3.14 mug/ml +/- 0.09 during dialysis. Their difference was not statistically significant, indicating that hemodialysis does not affect the blood level of clindamycin. In all studies, significant levels of the antibiotic were present at 12 hr.