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The belief that a favorable physiological milieu in the urinary tract may augment the effectiveness of antimicrobial agents used to treat urinary tract infections was examined by using an experimental model of Escherichia coli-induced renal infection in rats. The effect of manipulating urinary pH and flow on the antimicrobial activities of gentamicin, carbenicillin, ampicillin, nitrofurantoin and co-trimoxazole was assessed. In addition, a potential synergistic effect of the sequential administration of gentamicin and cephalothin in the eradication of renal infection was investigated. Although significant physiological alterations were achieved, these did not affect the efficacy of the antimicrobial agents studied, and therapeutic failures were common.

Effect of physiological manipulations on the chemotherapy of experimentally induced renal infection