Combined effect of clarithromycin and imipenem/cilastatin against urinary biofilm infection after pyeloplasty

Int J Urol. 2003 Apr;10(4):228-30. doi: 10.1046/j.0919-8172.2003.00598.x.

Abstract

The present report concerns a 38-year-old man, who had been treated with pyeloplasty and lithotomy for the improvement of urinary excretion and resolution of a kidney stone. The patient developed a biofilm infection involving Pseudomonas aeruginosa and Staphylococcus epidermidis, and had been suffering from recurrent acute pyelonephritis for one year. Combination therapy with clarithromycin (CAM) and imipenem/cilastatin (IMP/CS) consisted of administration of CAM at a dose of 400 mg/day for 1 week, followed by 500 mg/day of IMP by intravenous infusion combined with CAM (400 mg/day) for 5 days. This therapy produced an immediate antimicrobial effect and no further signs of pyuria have been seen during one year of follow-up in this patient.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biofilms / drug effects*
  • Biofilms / growth & development
  • Cilastatin / therapeutic use
  • Clarithromycin / therapeutic use
  • Drug Therapy, Combination / therapeutic use*
  • Humans
  • Imipenem / therapeutic use
  • Kidney Calculi / complications
  • Kidney Calculi / surgery
  • Kidney Pelvis / surgery
  • Male
  • Postoperative Complications*
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / isolation & purification*
  • Pyelonephritis / microbiology
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Staphylococcus epidermidis / isolation & purification*
  • Treatment Outcome
  • Ureteral Obstruction / complications
  • Ureteral Obstruction / surgery

Substances

  • Cilastatin
  • Imipenem
  • Clarithromycin