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Poletajew S, Brzózka MM, Krajewski W, Kamecki H, Nyk Ł, Kryst P. Glycosaminoglycan Replacement Therapy with Intravesical Instillations of Combined Hyaluronic Acid and Chondroitin Sulfate in Patients with Recurrent Cystitis, Post-radiation Cystitis and Bladder Pain Syndrome: A Narrative Review. Pain Ther 2024; 13:1-22. [PMID: 37917298 PMCID: PMC10796878 DOI: 10.1007/s40122-023-00559-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
Defects in the glycosaminoglycan layer (GAG) of the bladder mucosa have been identified as a significant contributor to the pathogenesis and clinical progression of chronic inflammatory diseases of the bladder, such as post-radiation cystitis, bladder pain syndrome and recurrent urinary tract infections. This narrative review aims to explore the contemporary evidence on the role of GAG reconstitution with intravesical installations of hyaluronic acid and chondroitin sulfate in the management of those patients, with a goal to provide valuable insights for clinical practice. The reviewed studies consistently demonstrate that GAG reconstitution can result in varying degrees of clinical improvement in patients with post-radiation cystitis, bladder pain syndrome and recurrent urinary tract infections, and is associated with a very favorable safety profile. While the available evidence is growing, its level is still limited, mainly by relatively low number of randomized controlled trials, with small sample sizes. Further research with larger, well-designed trials is needed to solidify the findings and optimize the clinical application of GAG reconstitution.
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Affiliation(s)
- Sławomir Poletajew
- Second Department of Urology, Medical Centre of Postgraduate Education, Warsaw, Poland.
| | | | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, Wroclaw, Poland
| | - Hubert Kamecki
- Second Department of Urology, Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Łukasz Nyk
- Second Department of Urology, Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Piotr Kryst
- Second Department of Urology, Medical Centre of Postgraduate Education, Warsaw, Poland
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Kelly SH, Votaw NL, Cossette BJ, Wu Y, Shetty S, Shores LS, Issah LA, Collier JH. A sublingual nanofiber vaccine to prevent urinary tract infections. SCIENCE ADVANCES 2022; 8:eabq4120. [PMID: 36417519 PMCID: PMC9683704 DOI: 10.1126/sciadv.abq4120] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Urinary tract infections (UTIs) are a major public health problem affecting millions of individuals each year. Recurrent UTIs are managed by long-term antibiotic use, making the alarming rise of antibiotic resistance a substantial threat to future UTI treatment. Extended antibiotic regimens may also have adverse effects on the microbiome. Here, we report the use of a supramolecular vaccine to provide long-term protection against uropathogenic Escherichia coli, which cause 80% of uncomplicated UTIs. We designed mucus-penetrating peptide-polymer nanofibers to enable sublingual (under the tongue) vaccine delivery and elicit antibody responses systemically and in the urogenital tract. In a mouse model of UTI, we demonstrate equivalent efficacy to high-dose oral antibiotics but with significantly less perturbation of the gut microbiome. We also formulate our vaccine as a rapid-dissolving sublingual tablet that raises response in mice and rabbits. Our approach represents a promising alternative to antibiotics for the treatment and prevention of UTIs.
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Lelie‐van der Zande R, Koster ES, Teichert M, Bouvy ML. Womens' self-management skills for prevention and treatment of recurring urinary tract infection. Int J Clin Pract 2021; 75:e14289. [PMID: 33928723 PMCID: PMC8365691 DOI: 10.1111/ijcp.14289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The guideline on urinary tract infections (UTI) of the Dutch College of General Practitioners provides recommendations on patient-initiated treatment and prevention of recurring UTI. AIM To study familiarity with self-management skills for prevention of recurring UTI amongst adult women. DESIGN AND SETTINGS An online questionnaire was developed, based on the UTI guideline and interviews with women having recurring UTI. Pharmacists in a postgraduate education programme (N = 76) aimed to invite 10 adult women with a recurring UTI prescription to complete the questionnaire. Women were asked for informed consent to link medication record data to questionnaire data. METHOD We calculated proportions of the scores for self-management skills and analysed differences between age groups with chi-square test. RESULTS Complete questionnaires were available for 719 women (mean age 55.1 ± 18.5 years). The proportions of women 18-50 years and women 51 years or older were 36.4% and 63.6%, respectively. Education levels of women 18-50 years were significantly higher than those of women 51 years and older. Before consulting a general practitioner (GP) for symptoms, 32.1% of all women increased fluid intake; additionally, 15.0% used analgesics and increased fluid intake. Of all women, 33.9% searched internet for information on self-management and 18% occasionally received a prescription for patient-initiated treatment, half of these prescriptions for use during vacation. Cranberry was used by 47%, d-mannose by 5% and vitamin C by 29% of all women. Awareness of different preventive behavioural measures (eg, fluid intake, washing without soap and emptying bladder after sexual intercourse) varied between 20% and 90%. CONCLUSION Almost half of all women applied self-management (increased fluid intake, analgesics) before consulting a GP for recurring UTI. Awareness of preventive behavioural measures for recurring UTI varied considerably. Thus, education of women about the use of analgesics and behavioural measures deserves attention.
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Affiliation(s)
- Rian Lelie‐van der Zande
- Department of Pharmacoepidemiology and Clinical PharmacologyUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - Ellen S. Koster
- Department of Pharmacoepidemiology and Clinical PharmacologyUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - Martina Teichert
- Department of Clinical Pharmacy and ToxicologyLeiden University Medical CenterLeidenThe Netherlands
| | - Marcel L. Bouvy
- Department of Pharmacoepidemiology and Clinical PharmacologyUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
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Gonzales Favoreto M, Pereira Gregorio E, Averbeck MA, de Almeida SHM. Independent validation of a predictive nomogram for risk of reinfection in women with recurrent non-complicated urinary tract infections. Ther Adv Urol 2020; 12:1756287220922423. [PMID: 32435277 PMCID: PMC7225790 DOI: 10.1177/1756287220922423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 03/30/2020] [Indexed: 12/29/2022] Open
Abstract
Aims: Independent external validation of a predictive nomogram for risk of reinfection in women with a history of non-complicated recurrent urinary tract infection (UTI). Methods: A retrospective longitudinal study was conducted to validate the LUTIRE nomogram in a Brazilian female cohort. The nomogram was applied to 81 women presenting non-complicated recurring UTI screened at a urological clinic. External validation was performed using the nomogram variables in patients followed up from January 2014 to December 2016 at a urological clinic. Accuracy of the nomogram was obtained by analyzing the predictive capacity observed in the area under the receiver operating characteristic (ROC) curve. A multivariate logistic regression model was used to assess the ability of the nomogram variables to predict the recurrence of UTI over 12 months. The time to recurrence of infection was calculated using a Kaplan–Meier curve and the log-rank test with calculation of the hazard ratio. Results: The mean age of the study population was 42.8 years; 57 women (70.37%) had recurrence. The independent variables with statistical significance in the multivariate analysis were gram-negative bacteria [odds ratio (OR) 18.38; p = 0.03897] and number of UTIs in the past 12 months (OR 25.11; p = 0.00006). The accuracy of the nomogram for discriminating patients who had UTI recurrence was 82.6% (95% CI = 72.5–90.1). Conclusion: The LUTIRE nomogram showed good accuracy among Brazilian women with recurrent UTI.
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Affiliation(s)
- Marcelo Gonzales Favoreto
- Postgraduation Program in Medicine and Health Sciences at State University of Londrina (UEL), Londrina, Brazil
| | | | - Marcio Augusto Averbeck
- Head of Neuro-Urology, Video-Urodynamics Unit, Moinhos de Vento Hospital, Rua Tiradentes, 333, 6th floor, Porto Alegre, RS 90560-030, Brazil
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Cai T, Palagin I, Brunelli R, Cipelli R, Pellini E, Truzzi JC, Van Bruwaene S. Office-based approach to urinary tract infections in 50 000 patients: results from the REWIND study. Int J Antimicrob Agents 2020; 56:105966. [PMID: 32325202 DOI: 10.1016/j.ijantimicag.2020.105966] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/23/2020] [Accepted: 03/28/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The REWIND study sought to describe the real-world clinical and prescribing practices for the management of urinary tract infection (UTI) in Italy, Belgium, Russia and Brazil in order to compare current practices with international, European and national guidelines. METHODS An integrated mixed-methods approach was adopted that used information from primary care electronic medical records in longitudinal patient databases available in Italy and Belgium, and surveys of physicians in Russia (general practitioners) and Brazil (gynaecologists). RESULTS In total, 49 548 female patients were included in the study. Antibiotics were the most common management option for UTI in Italy (71.1%, n=27 600), Belgium (92.4%, n=7703), Russia (81.9%, n=1231) and Brazil (82.4%, n=740). Fosfomycin trometamol was the first-choice antibiotic for the treatment of UTI in all countries. Ciprofloxacin was also commonly prescribed in Italy (24.6%, n=6796), Belgium (17.8%, n=1373), Russia (14.9%, n=184) and Brazil (9.6%, n=71), while prescription of nitrofurantoin was common in Belgium (24.5%, n=1890) alone. CONCLUSIONS Despite differences in study designs and data sources, fosfomycin trometamol was found to be the most commonly prescribed treatment for UTI in all participating countries. In Belgium, real-world prescribing practices for UTI adhered more closely to European guidelines than national guidelines. Although not recommended in international and European guidelines for lower UTI management, the use of fluoroquinolones was still widespread.
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Affiliation(s)
- Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Ivan Palagin
- Institute of Antimicrobial Chemotherapy of Smolensk State Medical University, Smolensk, Russian Federation
| | - Roberto Brunelli
- Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I Hospital, 'Sapienza' University of Rome, Rome, Italy
| | | | - Eliano Pellini
- Department of Gynaecology, Faculdade de Medicina do ABC, São Paulo, Brazil
| | - José Carlos Truzzi
- Division of Urology - Medical Student Health Service, Federal University of São Paulo, São Paulo, Brazil
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Scarneciu I, Bungau S, Lupu AM, Scarneciu CC, Bratu OG, Martha O, Tit DM, Aleya L, Lupu S. Efficacy of instillation treatment with hyaluronic acid in relieving symptoms in patients with BPS/IC and uncomplicated recurrent urinary tract infections - Long-term results of a multicenter study. Eur J Pharm Sci 2019; 139:105067. [DOI: 10.1016/j.ejps.2019.105067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 12/27/2022]
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Correlation of Antibiotic Resistance and Restriction Mapping of Plasmid DNA Isolated from E. coli Causing Urinary Tract Infection. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2019. [DOI: 10.22207/jpam.13.2.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ge IY, Fevrier HB, Conell C, Kheraj MN, Flint AC, Smith DS, Herrinton LJ. Reducing risk of Clostridium difficile infection and overall use of antibiotic in the outpatient treatment of urinary tract infection. Ther Adv Urol 2018; 10:283-293. [PMID: 30186366 DOI: 10.1177/1756287218783871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 05/29/2018] [Indexed: 11/17/2022] Open
Abstract
Background Risk of community-acquired Clostridium difficile infection (CA-CDI) following antibiotic treatment specifically for urinary tract infection (UTI) has not been evaluated. Methods We conducted a nested case-control study at Kaiser Permanente Northern California, 2007-2010, to assess antibiotic prescribing and other factors in relation to risk of CA-CDI in outpatients with uncomplicated UTI. Cases were diagnosed with CA-CDI within 90 days of antibiotic use. We used matched controls and confirmed case-control eligibility through chart review. Antibiotics were classified as ciprofloxacin (most common), or low risk (nitrofurantoin, sulfamethoxazole/trimethoprim), moderate risk, or high risk (e.g. cefpodoxime, ceftriaxone, clindamycin) for CDI. We computed the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the relationship of antibiotic treatment for uncomplicated UTI and history of relevant gastrointestinal comorbidity (including gastrointestinal diagnoses, procedures, and gastric acid suppression treatment) with risk of CA-CDI using logistic regression analysis. Results Despite the large population, only 68 cases were confirmed with CA-CDI for comparison with 112 controls. Female sex [81% of controls, adjusted odds ratio (OR) 6.3, CI 1.7-24), past gastrointestinal comorbidity (prevalence 39%, OR 2.3, CI 1.1-4.8), and nongastrointestinal comorbidity (prevalence 6%, OR 2.8, CI 1.4-5.6) were associated with increased CA-CDI risk. Compared with low-risk antibiotic, the adjusted ORs for antibiotic groups were as follows: ciprofloxacin, 2.7 (CI 1.0-7.2); moderate-risk antibiotics, 3.6 (CI 1.2-11); and high-risk antibiotics, 11.2 (CI 2.4-52). Conclusions Lower-risk antibiotics should be used for UTI whenever possible, particularly in patients with a gastrointestinal comorbidity. However, UTI can be managed through alternative approaches. Research into the primary prevention of UTI is urgently needed.
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Affiliation(s)
- Ivy Y Ge
- Inpatient Pharmacy, Kaiser Permanente Northern California South San Francisco Medical Center, 1200 El Camino Real, 3rd Floor, South San Francisco, CA 94080, USA
| | | | - Carol Conell
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Malika N Kheraj
- Department of Infectious Disease, Kaiser Permanente Redwood City Medical Center, Redwood City, CA, USA
| | - Alexander C Flint
- Department of Neurology, Kaiser Permanente Redwood City Medical Center, Redwood City, CA, USA
| | - Darvin S Smith
- Department of Infectious Disease, Kaiser Permanente Redwood City Medical Center, Redwood City, CA, USA
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Ng QX, Peters C, Venkatanarayanan N, Goh YY, Ho CYX, Yeo WS. Use of Lactobacillus spp. to prevent recurrent urinary tract infections in females. Med Hypotheses 2018; 114:49-54. [PMID: 29602464 DOI: 10.1016/j.mehy.2018.03.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 02/27/2018] [Accepted: 03/03/2018] [Indexed: 01/21/2023]
Abstract
Urinary tract infections (UTIs) are the most common bacterial infections seen in the community, especially amongst females. The widespread use of antibiotics has led to the increased occurrence of E. coli resistant isolates worldwide. A promising non-antibiotic approach is the use of probiotic lactobacilli strains. This paper hypothesizes that Lactobacillus spp. containing products are able to prevent recurrent urinary tract infections in females. Using the keywords [lactobacillus OR lactobacilli OR probiotic] and [urinary tract infection OR UTI OR cystitis], a preliminary search on the PubMed, Ovid, Google Scholar and ClinicalTrials.gov database yielded 1,647 papers published in English between 1-Jan-1960 and 1-May-2017. 9 clinical trials with a total of 726 patients were reviewed. Different lactobacilli strains (in either oral or suppository formulation) were utilized and they demonstrated varying efficacy in the prevention of recurrent UTIs. Using a random-effects model, pooled risk ratio of at least one recurrent UTI episode during the entire study duration was 0.684 (95% CI 0.438 to 0.929, p < 0.001), per-protocol analysis. However, key limitations include significant inter-study variability and the limited duration of follow-up of most studies. Our hypothesis on the chemoprophylactic effects of probiotics for UTIs is plausible and supported by current data. Lactobacillus rhamnosus GR1 and Lactobacillus reuteri RC14 were the most commonly studied lactobacilli strains. Further and more robust randomized controlled trials with standardized lactobacilli strains and formulation are required for confirmation of effects.
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Affiliation(s)
- Qin Xiang Ng
- Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore.
| | - Christina Peters
- University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom
| | - Nandini Venkatanarayanan
- University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom
| | - Yan Yih Goh
- Anglo Singapore International School, Sukhumvit 64, Bangchark, Prakanong, Bangkok 10260, Thailand
| | - Collin Yih Xian Ho
- National University Hospital, National University Health System, 119074, Singapore
| | - Wee-Song Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore; National University Hospital, National University Health System, 119074, Singapore
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Terlizzi ME, Gribaudo G, Maffei ME. UroPathogenic Escherichia coli (UPEC) Infections: Virulence Factors, Bladder Responses, Antibiotic, and Non-antibiotic Antimicrobial Strategies. Front Microbiol 2017; 8:1566. [PMID: 28861072 PMCID: PMC5559502 DOI: 10.3389/fmicb.2017.01566] [Citation(s) in RCA: 334] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/02/2017] [Indexed: 12/21/2022] Open
Abstract
Urinary tract infections (UTIs) are one of the most common pathological conditions in both community and hospital settings. It has been estimated that about 150 million people worldwide develop UTI each year, with high social costs in terms of hospitalizations and medical expenses. Among the common uropathogens associated to UTIs development, UroPathogenic Escherichia coli (UPEC) is the primary cause. UPEC strains possess a plethora of both structural (as fimbriae, pili, curli, flagella) and secreted (toxins, iron-acquisition systems) virulence factors that contribute to their capacity to cause disease, although the ability to adhere to host epithelial cells in the urinary tract represents the most important determinant of pathogenicity. On the opposite side, the bladder epithelium shows a multifaceted array of host defenses including the urine flow and the secretion of antimicrobial substances, which represent useful tools to counteract bacterial infections. The fascinating and intricate dynamics between these players determine a complex interaction system that needs to be revealed. This review will focus on the most relevant components of UPEC arsenal of pathogenicity together with the major host responses to infection, the current approved treatment and the emergence of resistant UPEC strains, the vaccine strategies, the natural antimicrobial compounds along with innovative anti-adhesive and prophylactic approaches to prevent UTIs.
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Affiliation(s)
| | | | - Massimo E. Maffei
- Department of Life Sciences and Systems Biology, University of TurinTorino, Italy
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Mandaric L, Diamantini E, Stella E, Cano-Paoli K, Valle-Sistac J, Molins-Delgado D, Bellin A, Chiogna G, Majone B, Diaz-Cruz MS, Sabater S, Barcelo D, Petrovic M. Contamination sources and distribution patterns of pharmaceuticals and personal care products in Alpine rivers strongly affected by tourism. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 590-591:484-494. [PMID: 28284634 DOI: 10.1016/j.scitotenv.2017.02.185] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/22/2017] [Accepted: 02/22/2017] [Indexed: 06/06/2023]
Abstract
Knowledge regarding the impact of tourism on the emergence of pharmaceuticals and personal care products (PPCPs) in Alpine river waters is limited and scarce. Therefore, a study on the occurrence patterns and spatiotemporal variability of 105 PPCPs in an Alpine river basin located in the Trentino-Alto Adige region (North-Eastern Italy) has been conducted. We observed that the total concentration of analyzed PPCPs was generally higher in all sampling sites during winter than in the summer. The analysis of tourist data revealed that during both sampling campaigns the number of tourists was lower in the downstream sites in comparison with the upstream area of the basin (Val di Sole). Particularly, sampling sites located near important tourist resorts have shown the highest abundance of the PPCPs during winter, being analgesics/anti-inflammatories, antihypertensives and antibiotics the most abundant pharmaceutically active compounds (PhACs). Diclofenac showed the highest concentration amongst PhACs, reaching concentrations up to 675ngL-1 in the sampling site situated downstream of the Tonale wastewater treatment plant (WWTP). Antihypertensives were found at concentrations >300ngL-1, while antibiotics were quantified up to 196ngL-1, respectively. Amongst personal care products (PCPs), the most abundant compound was octyl-dimethyl-p-aminobenzoic acid (ODPABA) with concentrations reaching up to 748ngL-1 in the sampling site situated within the Rotaliana district. In general, concentrations and detection frequencies were higher in water than in the sediment samples. The most frequently detected PhACs in sediments from both sampling campaigns were antibiotics, while amongst PCPs in sediments, octocrylene (OC) showed the highest concentration in both sampling campaigns. As a result, this study highlights the potential impact of tourism on the water quality of the Alpine aquatic ecosystems.
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Affiliation(s)
- Ladislav Mandaric
- Catalan Institute for Water Research (ICRA), C/Emili Grahit, 101 E, 17003 Girona, Spain
| | - Elena Diamantini
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano, 77, Trento I-38123, Italy
| | - Elisa Stella
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano, 77, Trento I-38123, Italy
| | - Karina Cano-Paoli
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano, 77, Trento I-38123, Italy
| | - Jennifer Valle-Sistac
- Department of Environmental Chemistry IDAEA-CSIC, C/Jordi Girona, 18-26, 08034 Barcelona, Spain
| | - Daniel Molins-Delgado
- Department of Environmental Chemistry IDAEA-CSIC, C/Jordi Girona, 18-26, 08034 Barcelona, Spain
| | - Alberto Bellin
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano, 77, Trento I-38123, Italy
| | - Gabriele Chiogna
- Faculty of Civil, Geo and Environmental Engineering, Technical University of Munich, Arcistrasse 21, Munich 80333, Germany; Institute of Geography, University of Innsbruck, Innrain 52, 6020 Innsbruck, Austria
| | - Bruno Majone
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano, 77, Trento I-38123, Italy
| | - M Silvia Diaz-Cruz
- Department of Environmental Chemistry IDAEA-CSIC, C/Jordi Girona, 18-26, 08034 Barcelona, Spain
| | - Sergi Sabater
- Catalan Institute for Water Research (ICRA), C/Emili Grahit, 101 E, 17003 Girona, Spain; Institute of Aquatic Ecology, University of Girona, Campus de Montilivi, 17071 Girona, Spain
| | - Damia Barcelo
- Catalan Institute for Water Research (ICRA), C/Emili Grahit, 101 E, 17003 Girona, Spain; Department of Environmental Chemistry IDAEA-CSIC, C/Jordi Girona, 18-26, 08034 Barcelona, Spain
| | - Mira Petrovic
- Catalan Institute for Water Research (ICRA), C/Emili Grahit, 101 E, 17003 Girona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Lluis Company 25, 08010 Barcelona, Spain.
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Fosfomycin for UTIs. Drug Ther Bull 2016; 54:114-117. [PMID: 27737907 DOI: 10.1136/dtb.2016.10.0429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Fosfomycin trometamol is a broad spectrum antibiotic recently marketed in the UK for the treatment of acute uncomplicated lower urinary tract infections (UTIs) in adults1,2 and in adult and adolescent females.3 It is also indicated for prophylaxis in diagnostic and surgical transurethral procedures.1-3 Fosfomycin was discovered in 1969 and the reference drug was first marketed as Monuril in France in 1986.3,4 Although Monuril had UK marketing authorisation, it was never distributed in the UK. However, national guidance included the option of using unlicensed imported fosfomycin.3,5,6 Branded and generic versions of fosfomycin are now available in the UK,1-3,7 and here we review the evidence for their use in the treatment of UTIs.
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