Wagenlehner Florian M E, Weidner Wolfgang, Naber Kurt G
Urologic Clinic, Hospital St. Elisabeth, St. Elisabeth Street. 23, D-94315 Straubing, Germany.
Expert Opin Emerg Drugs. 2005 May;10(2):275-98. doi: 10.1517/14728214.10.2.275.
Bacterial urinary tract infections (UTIs) are frequent infections in the outpatient as well as in the nosocomial setting. The stratification into uncomplicated and complicated UTIs has proven to be clinically useful. Bacterial virulence factors on the one side and the integrity of the host defence mechanisms on the other side determine the course of the infection. In uncomplicated UTIs, Escherichia coli is the leading organism, whereas in complicated UTIs, the bacterial spectrum is much broader, including Gram-negative, Gram-positive and often multiresistant organisms. The therapy of uncomplicated UTIs is almost exclusively antibacterial, whereas in complicated UTIs the complicating factors also have to be treated. There are two predominant aims in the antimicrobial treatment of both uncomplicated and complicated UTIs: i) rapid and effective response to therapy and prevention of recurrence of the individual patient treated; and ii) prevention of emergence of resistance to chemotherapy in the microbial environment. The aim of this review is to highlight the existing, and to describe emerging, treatment options for UTIs.
细菌性尿路感染（UTIs）在门诊和医院环境中都是常见的感染。将UTIs分为单纯性和复杂性UTIs已被证明在临床上是有用的。一方面是细菌毒力因子，另一方面是宿主防御机制的完整性，两者共同决定感染的进程。在单纯性UTIs中，大肠埃希菌是主要病原体，而在复杂性UTIs中，细菌谱要广泛得多，包括革兰氏阴性菌、革兰氏阳性菌，且常常是多重耐药菌。单纯性UTIs的治疗几乎完全是抗菌治疗，而在复杂性UTIs中，还必须治疗其复杂因素。单纯性和复杂性UTIs的抗菌治疗有两个主要目标：i）对治疗迅速产生有效反应并预防接受治疗的个体患者复发；ii）防止微生物环境中出现对化疗的耐药性。本综述的目的是强调现有的UTIs治疗选择，并描述新出现的治疗选择。
