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Last update 08 May 2025

Pyuria

Last update 08 May 2025

Basic Info

Synonyms

High urine neutrophil count, PYURIA, Pus cells in urine

+ [27]

Introduction

The presence of white blood cells (LEUKOCYTES) in the urine. It is often associated with bacterial infections of the urinary tract. Pyuria without BACTERIURIA can be caused by TUBERCULOSIS, stones, or cancer.

Drugs associated with Pyuria

Gepotidacin

Target

Bacterial DNA gyrase x Bacterial top IV x Top II

Mechanism

Bacterial DNA gyrase inhibitors [+2]

Active Org.

GSK Plc [+3]

Originator Org.

GSK Plc

Active Indication

Bacterial Infections [+5]

Inactive Indication

Respiratory Tract Infections [+1]

Drug Highest PhaseApproved

First Approval Ctry. / Loc.

United States

First Approval Date25 Mar 2025

Tebipenem Pivoxil

Target

PBPs

Mechanism

PBPs inhibitors

Active Org.

GSK Plc [+5]

Originator Org.

Meiji Seika Pharma Co., Ltd.

Active Indication

Otitis Media [+6]

Inactive Indication

Complicated urinary tract infection [+3]

Drug Highest PhaseApproved

First Approval Ctry. / Loc.

Japan

First Approval Date22 Apr 2009

Clinical Trials associated with Pyuria

NCT06597344

/ CompletedPhase 3

A Phase 3b, Open-label, Single-arm Study in Adolescent and Adult Female Participants to Evaluate Clinical Symptom Improvement and the Safety of Gepotidacin During Treatment of Uncomplicated Urinary Tract Infections (Acute Cystitis)

The study will be conducted to evaluate the clinical symptom improvement and safety of oral gepotidacin for treatment of uncomplicated UTI (acute cystitis) in adolescent and adult female participants.

Start Date02 Oct 2024

Sponsor / Collaborator

GSK Plc

CTRI/2024/04/066014

/ Not yet recruitingPhase 2/3

A Phase II/III, Randomized, Double-blind, Multicenter, Comparative Study to Determine the Efficacy and Safety of Cefepime- Tazobactam (WCK 4282) vs. Meropenem in the Treatment of Complicated Urinary Tract Infection or Acute Pyelonephritis in Adults - NIL

Start Date25 Apr 2024

Sponsor / Collaborator-

NCT06059846

/ RecruitingPhase 3

A Phase 3, Randomized, Double-blind, Double-dummy, Multicenter, Multinational Study to Assess the Efficacy and Safety of Orally Administered Tebipenem Pivoxil Hydrobromide (TBP-PI-HBr) Compared to Intravenously Administered Imipenem-cilastatin in Patients With Complicated Urinary Tract Infection (cUTI) or Acute Pyelonephritis (AP)

The primary purpose of this study is to assess the efficacy of oral TBP-PI-HBr as compared with intravenous (IV) imipenem-cilastatin with respect to the overall response (combined clinical cure plus microbiological eradication) at the Test-of-Cure (TOC) visit in hospitalized adult participants (≥18 years of age) with cUTI or AP.

Start Date21 Dec 2023

Sponsor / Collaborator

Spero Therapeutics, Inc.

[+1]

100 Clinical Results associated with Pyuria

100 Translational Medicine associated with Pyuria

0 Patents (Medical) associated with Pyuria

2,580

Literatures (Medical) associated with Pyuria

01 May 2025·Acta Paediatrica

Clinical outcomes in febrile children with a positive urine culture without pyuria: Implications for antibiotics

Article

Author: Miyake, Rei ; Hataya, Hiroshi

AbstractAimThis study aimed to investigate whether antibiotics should be administered to patients aged <2 years with a positive urine culture without pyuria by identifying their clinical characteristics and outcomes in the absence of antibiotic treatment.MethodsThis retrospective, observational study included children aged <2 years with positive findings on a culture of urine obtained using a catheter in the paediatric emergency department between 2016 and 2021. The primary outcome was the spontaneous resolution of fever without antibiotics in patients with a positive urine culture without pyuria. The clinical characteristics of the patients with and without pyuria were also compared.ResultsOf 391 patients, 86 (22%) were negative for pyuria. Of these, 63 (73%) received no antibiotics, and 56 (89%) had spontaneous defervescence and no symptom recurrence. The patients without pyuria had a higher proportion of other possible causes of fever, lower inflammatory markers, fewer cultured bacteria, and a higher proportion of multiple, bacterial species in their culture than the patients with pyuria.ConclusionsMost of the patients with a positive urine culture without pyuria may not require antibiotics if their fever resolves spontaneously.

16 Apr 2025·Zhonghua er ke za zhi = Chinese journal of pediatrics

[Clinical analysis of pediatric renal abscess].

Article

Author: Tu, J ; Sun, J S ; Chen, C Y ; Geng, H Y ; Li, H R ; Yan, Y C ; Wan, L

Objective: To analyze the clinical characteristics of renal abscess in children and provide suggestions for early diagnosis and treatment. Methods: The clinical data including general information, laboratory data, imaging results, treatment and prognosis of 20 pediatric patients with renal abscess admitted to the Department of Nephrology, Capital Center for Children's Health Capital Medical University were analyzed retrospectively. Results: A total of 8 males and 12 females were enrolled. The age of onset was 3.0 (0.8, 9.0) years. All cases had fever. Six cases presented with abdominal pain, 6 cases had poor appetite, 5 cases had vomiting and 5 acses urinary tract irritation symptoms. Laboratory data showed elevated white blood cells 20.4 (17.4,26.3)×10⁹/L, C-reactive protein 126 (77, 154)mg/L, erythrocyte sedimentation rate 60 (41,73) mm/1 h in 20 cases and procalcitonin 4.7 (1.2,33.5)μg/L in 10 cases. Totally 18 cases had pyuria. Urine culture was positive in 8 cases. Enterococcus faecium and Pseudomonas aeruginosa was detected in 2 cases. Klebsiella pneumoniae was found in 1 case after performing blood culture. Renal abscess was confirmed in all cases by doing contrast-enhanced CT scan, while only 9 cases with abscesses were identified by using renal ultrasound. There were 14 cases with renal abscess formation confirmed at onset by performing magnetic resonance imaging. Nine cases were accompanied with congenital anomalies of the kidney and urinary tract. All cases received conservative medical treatment. Intravenous broad-spectrum antibiotics were administered for at 23 (14, 39)d initially, while the medication in 11 cases were upgraded to meropenem or imipenem. Oral antibiotics were continued for 23 (14, 28)d after discharge in all cases. Within 1 year of follow-up, except for 1 case of recurrence, the others had a favorable prognosis. Conclusions: Renal abscess should be suspected for children presenting with unexplained fever, vomiting, abdominal pain, elevated white blood cell count, C-reactive protein, erythrocyte sedimentation rate and pyuria. Ultrasonography is suitable for screening and follow-up, while CT or magnetic resonance imaging can be used to confirm the diagnosis. Conservative management with broad-spectrum antibiotics is effective and can be considered the first-line therapy for pediatric renal abscess.

01 Apr 2025·Microbiology Spectrum

Exploring the association between the degree of pyuria and urinary tract infections

Article

Author: Cronin, Katie ; Bond, Katherine ; Chan, Eddie ; Tien, Hsin ; Hong, Wei

ABSTRACT We aim to define the optimal white cell count threshold that correlates with a clinically significant urinary tract infection, as there is insufficient data exploring this in the adult population. We conducted a retrospective cohort study at the Royal Melbourne Hospital analyzing urine samples collected over 6 months in 2022. Urinary tract infection (UTI) was defined as the presence of symptoms (dysuria, urgency, frequency, flank pain, or loin to groin pain) and isolation of a uropathogen with colony counts greater than 10 7 CFU/L. The relationship between urinary white cell count, growth of uropathogen, and likelihood of UTI was estimated using locally weighted scatterplot smoothing. Of the 6,328 samples included, at a urinary white cell count of less than 10 per microliter, 38% grew a microorganism, while 7% of the total grew a uropathogen. For our sub-analysis part C, at the same WBC count, 2% of samples fulfilled our criteria for UTI. The optimal WBC range for identifying a UTI was 30–50 WBC/µL, demonstrating the most pragmatic balance of sensitivity (92.3%–94.9%, 95% CI 85.9–98.1) and specificity (41.6–47.2, 95% CI 38.6%–50.3%) for a UTI. A lower-than-expected number of UTIs were confirmed in our study, likely due to inappropriate indications for culture collection and the types of urine specimens collected. However, the optimal white cell cutoff for identifying a UTI was higher than the defined pyuria cutoff of 10 WBC/µL. Utilizing a higher urinary WBC cutoff could improve urine culture processing protocols. IMPORTANCEThe importance of this study is that it explores the optimal range of white cell count that defines a clinically significant urinary tract infection. The traditional cutoff of more than 10 white blood cells per microliter is often used; however, we now recognize that using this cutoff may not accurately represent true urinary infections, especially in certain populations such as young women. The uncertainty in the optimal white cell count cutoff has widespread implications. For the clinician, it may lead to unnecessary prescribing of antibiotics for patients who do not have a Urinary tract infection, such as asymptomatic bacteriuria. For the microbiology laboratory, it may lead to unnecessary workup and culture of urine samples that are not clinically relevant. Many studies to date have attempted to define an optimal value for urinary white cell count; however, not many have incorporated relevant clinical data, which this study has.

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