Predictive Effect of Urinary Concentrating Ability and Hemagglutinating Antibody Titer upon Response to Antimicrobial Therapy in Bacteriuria of Pregnancy

Urinary concentrating ability, hemagglutinating antibody (HA) titers, results of intravenous pyelography, and response to antimicrobial therapy were studied in 172 pregnancies among bacteriuric women. Eighty-eight were treated with sulfasymazine and 84 with placebo in a double-blind trial. The mean...

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Bibliographic Details
Published in:The Journal of infectious diseases 1970-06, Vol.121 (6), p.588-596
Main Authors: Norden, Carl W., Levy, Paul S., Kass, Edward H.
Format: Article
Language:English
Subjects:
Antibodies
Antibodies - analysis
Antimicrobials
Bacteriuria
Bacteriuria - diagnostic imaging
Bacteriuria - drug therapy
Bacteriuria - immunology
Bacteriuria - physiopathology
Clinical Trials as Topic
Female
Hemagglutination Tests
Humans
Infections
Kidney - physiopathology
Kidney Concentrating Ability
Obstetric Labor, Premature - etiology
Original Articles
Placebos
Pregnancy
Pregnancy Complications, Infectious - drug therapy
Prognosis
Pyelonephritis
Pyelonephritis - diagnosis
Radiography
Sulfonamides
Sulfonamides - therapeutic use
Triazines - therapeutic use
Urine
Urography
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Summary:Urinary concentrating ability, hemagglutinating antibody (HA) titers, results of intravenous pyelography, and response to antimicrobial therapy were studied in 172 pregnancies among bacteriuric women. Eighty-eight were treated with sulfasymazine and 84 with placebo in a double-blind trial. The mean urinary osmolality for patients with bacteriuria was significantly less (P< .01) than that for matched nonbacteriuric women. A significant association between impaired urinary concentrating ability and elevation of HA titer was demonstrated. Patients with impaired concentrating ability failed to respond to a 2-week course of sulfonamide therapy significantly more frequently than did those patients with normal concentrating ability. No statistically significant association was demonstrated between elevation of HA titer and failure to respond to therapy. Of 7 patients with radiologic evidence of definite pyelonephritis, only 2 were treated successfully, in contrast to 9 patients with normal pyelograms, all of whom responded to a 2-week course of therapy. These observations indicate the need for controlled trials in pregnant women to determine the role of antibody titer and concentrating ability as predictors of overt pyelonephritis, prematurity, and response to antimicrobial therapy.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/121.6.588