Urinary tract infections in patients with severe renal disease. Treatment with ampicillin and trimethoprim-sulfamethoxazole

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Abstract
Twelve patients with severe renal failure and intercurrent urinary tract infections were treated with either ampicillin trihydrate, 500 mg 4 times a day, or trimethoprim-sulfamethoxazole, 2 tablets (80 mg trimethoprim, 400 mg sulfamethoxazole) twice a day. All patients achieved bacteriologic cure, including 6 with proved upper tract infection. Serum levels of all drugs were increased to values above those seen in normal subjects without adverse effects. Urine concentrations of trimethoprim, 28.6 .mu.g/ml, and ampicillin, 88.6 .mu.g/ml, were well above the minimum inhibitory concentrations of urinary pathogens. Urine sulfamethoxazole concentrations were less than 10 .mu.g/ml in 4 of the 6 patients treated, but this did not hamper bacteriologic success. Both drugs can apparently be used to treat urinary tract infections in patients with renal functional impairment.