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LE Nicolle

Publications and source records attributed to LE Nicolle.

5 recordsLinked to original sources
PubMed2000

Preface.

Although the clinical presentation and the treatment of lower urinary tract infection (UTI) have changed little in the 60 to 70 years of the 'antibiotic era', uropathogenic bacteria have not been slow to respond to the selecting pressure of antimicrobials. This is because such infections are common. Approximately 3% of all consultations made to general practitioners are for symptoms of UTI and approximately 12-20% of all antibiotic prescriptions are for this indication. Between one-quarter and one-half of all women experience a UTI at some time. The problem, therefore, is a considerable one and warrants reevaluation. This supplement is based upon papers presented at a meeting held in March 2000 in Vienna, Austria and sponsored by Leo Pharmaceutical Laboratories. It draws together the current views on the diagnosis and the treatment of UTIs at a time when the disease-causing microorganisms are most certainly changing. Antibiotic resistance to commonly used agents, such as trimethoprim and ampicillin, often now exceeds 30-50%. The clinician may be tempted to choose an agent such as a fluoroquinolone for the treatment of this disease, yet it is known that fluoroquinolone resistance can develop rapidly. Views on the length of treatment have also changed over the years and a 3 day regimen is usually now advocated. Pivmecillinam, which is hydrolysed to mecillinam after absorption, has a novel mode of action, rapid bacterial cell penetration and lower affinity for common beta-lactamases. Its spectrum of activity and good safety profile make it an ideal candidate for the treatment of this common condition. Experience in several countries over many years confirms this assessment and it may be time to reconsider the potential role of pivmecillinam in the treatment of UTIs. The Editors would like to thank Inge Boe and Paul Menday of Leo Laboratories for their untiring support and assistance in the preparation of this supplement.

Journal Article↗
PubMed2000

Preface.

Although the clinical presentation and the treatment of lower urinary tract infection (UTI) have changed little in the 60 to 70 years of the 'antibiotic era', uropathogenic bacteria have not been slow to respond to the selecting pressure of antimicrobials. This is because such infections are common. Approximately 3% of all consultations made to general practitioners are for symptoms of UTI and approximately 12-20% of all antibiotic prescriptions are for this indication. Between one-quarter and one-half of all women experience a UTI at some time. The problem, therefore, is a considerable one and warrants reevaluation. This supplement is based upon papers presented at a meeting held in March 2000 in Vienna, Austria and sponsored by Leo Pharmaceutical Laboratories. It draws together the current views on the diagnosis and the treatment of UTIs at a time when the disease-causing microorganisms are most certainly changing. Antibiotic resistance to commonly used agents, such as trimethoprim and ampicillin, often now exceeds 30-50%. The clinician may be tempted to choose an agent such as a fluoroquinolone for the treatment of this disease, yet it is known that fluoroquinolone resistance can develop rapidly. Views on the length of treatment have also changed over the years and a 3 day regimen is usually now advocated. Pivmecillinam, which is hydrolysed to mecillinam after absorption, has a novel mode of action, rapid bacterial cell penetration and lower affinity for common beta-lactamases. Its spectrum of activity and good safety profile make it an ideal candidate for the treatment of this common condition. Experience in several countries over many years confirms this assessment and it may be time to reconsider the potential role of pivmecillinam in the treatment of UTIs. The Editors would like to thank Inge Boe and Paul Menday of Leo Laboratories for their untiring support and assistance in the preparation of this supplement.

Journal Article↗
PubMed2000

Preface.

Although the clinical presentation and the treatment of lower urinary tract infection (UTI) have changed little in the 60 to 70 years of the 'antibiotic era', uropathogenic bacteria have not been slow to respond to the selecting pressure of antimicrobials. This is because such infections are common. Approximately 3% of all consultations made to general practitioners are for symptoms of UTI and approximately 12-20% of all antibiotic prescriptions are for this indication. Between one-quarter and one-half of all women experience a UTI at some time. The problem, therefore, is a considerable one and warrants reevaluation. This supplement is based upon papers presented at a meeting held in March 2000 in Vienna, Austria and sponsored by Leo Pharmaceutical Laboratories. It draws together the current views on the diagnosis and the treatment of UTIs at a time when the disease-causing microorganisms are most certainly changing. Antibiotic resistance to commonly used agents, such as trimethoprim and ampicillin, often now exceeds 30-50%. The clinician may be tempted to choose an agent such as a fluoroquinolone for the treatment of this disease, yet it is known that fluoroquinolone resistance can develop rapidly. Views on the length of treatment have also changed over the years and a 3 day regimen is usually now advocated. Pivmecillinam, which is hydrolysed to mecillinam after absorption, has a novel mode of action, rapid bacterial cell penetration and lower affinity for common beta-lactamases. Its spectrum of activity and good safety profile make it an ideal candidate for the treatment of this common condition. Experience in several countries over many years confirms this assessment and it may be time to reconsider the potential role of pivmecillinam in the treatment of UTIs. The Editors would like to thank Inge Boe and Paul Menday of Leo Laboratories for their untiring support and assistance in the preparation of this supplement.

Journal Article↗
PubMed2000

Pivmecillinam in the treatment of urinary tract infections.

The efficacy of pivmecillinam for empirical treatment of acute uncomplicated urinary tract infection (UTI) was initially reported in clinical trials published in the 1970s and 1980s. Bacteriological cure rates observed in these trials were consistently >85%, and studies of different dosing regimens suggested that a 3 day course was appropriate. Comparative studies reported that pivmecillinam was equivalent to other antimicrobial agents in terms of clinical and bacteriological outcomes. These studies also documented that pivmecillinam was effective for treatment of Staphylococcus saprophyticus infections, was acceptable for use in pregnancy and was well tolerated. Subsequent widespread use of pivmecillinam in Scandinavian countries has led to a body of clinical experience which confirms the efficacy and safety of this antimicrobial agent in the treatment of acute cystitis. Recently, two large, prospective, randomized, double-blind, multi-centre clinical trials have been completed to assist in defining the role of this antimicrobial agent in the treatment of acute cystitis. A comparison of 3 day courses of pivmecillinam or norfloxacin, both at 400 mg bd, showed higher bacteriological cure rates with norfloxacin but generally similar clinical outcomes. A second, dose-ranging study found that pivmecillinam, given bd for 7 days, led to superior bacteriological and clinical outcomes at short-term follow-up than the 3 day regimen. Pooling bacteriological outcomes from the two studies showed similar outcomes with 7 days of pivmecillinam 200 mg bd or 3 days of norfloxacin 400 mg bd. The shorter, 3 day, course achieved similar short-term clinical outcomes to 7 days of pivmecillinam and 3 days of norfloxacin in women aged </=50 years. These recent studies confirm earlier reports and clinical experience that pivmecillinam is effective and well tolerated for the treatment of acute cystitis in women.

Journal Article↗
PubMed1996

Management of Asymptomatic UTIs in Women.

Asymptomatic bacteriuria is common in women and increases markedly with age and functional impairment. Although asymptomatic bacteriuria frequently resolves spontaneously, it may persist for extended periods, particularly in older women. Programs to screen for and treat asymptomatic bacteriuria are appropriate only in pregnant women. For the general female population, screening and treatment programs for asymptomatic bacteriuria do not appear warranted.

Journal Article↗