Antibiotic treatment of complicated urologic infections. Six selected case studies.

The use of aminoglycosides in urology is limited primarily either to preoperative prophylaxis or to acutely ill patients. Frequently in this latter group, there is little margin for error, and the appropriate drug(s) must be given at the outset. In addition to receiving antibiotics, patients in distress should be resuscitated with fluids, evaluated to determine the cause of their sepsis, and promptly and definitively treated. It is important early in the course of therapy to drain the site of obstruction or abscess, remove foreign bodies, or debride necrotic areas if medical measures are to be successful. The rationale for selection of an aminoglycoside and treatment in these patients is discussed, using six case studies as illustrations.