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老年菌尿症患者长期喹诺酮治疗后的生存情况。

Survival of elderly bacteriuric subjects following long-term quinolone therapy.

作者信息

Giamarellou H, Dontas A S, Petrikkos G, Gnardellis C, Zorbas P, Philippou P

机构信息

Department of Internal Medicine, Athens University School of Medicine, Attikon University General Hospital, Athens, Greece.

出版信息

J Chemother. 2007 Apr;19(2):185-92. doi: 10.1179/joc.2007.19.2.185.

Abstract

This study aimed to determine whether long-term oral fluoroquinolone administration exerts a significant positive effect on mobility and mortality in elderly subjects with asymptomatic bacteriuria. 132 institutionalized patients were divided into 4 groups: groups A and B were treated with ofloxacin while groups C and D were positive and negative control groups. At 3 months following treatment discontinuation 57%, 53% and 26% of patients in groups A, B and C respectively had negative urine cultures and all subjects were alive. After 3 years, positive cultures were 41.7%, 54.5% and 42.9% respectively for uncatheterized subjects per group vs. 13.3% for group D. In groups A, B, and C 20%, 15% and 29% of survivors respectively had permanent bladder catheters vs. 11.5% of survivors of group D. Survival in groups A, B and C, combined or per group did not differ significantly from group D, although it was shorter. "Pulse" antibiotic administration tended to perform better, in terms of clearing infection and maintaining continence. At 3 years, bacteriuria recurred and the need for bladder catheterization was doubled. Mortality increased independently of treatment. More elderly bacteriuric subjects should be studied to evaluate mobility and mortality issues.

摘要

本研究旨在确定长期口服氟喹诺酮类药物对无症状菌尿老年患者的活动能力和死亡率是否有显著的积极影响。132名机构养老患者被分为4组:A组和B组用氧氟沙星治疗,而C组和D组分别为阳性和阴性对照组。在停药3个月时,A组、B组和C组分别有57%、53%和26%的患者尿培养转阴,且所有受试者均存活。3年后,每组未留置导尿管的受试者尿培养阳性率分别为41.7%、54.5%和42.9%,而D组为13.3%。在A组、B组和C组中,分别有20%、15%和29%的存活者留置永久性膀胱导尿管,而D组存活者的这一比例为11.5%。A组、B组和C组合并或每组的生存率与D组相比虽较短,但无显著差异。就清除感染和维持控尿而言,“脉冲式”抗生素给药效果似乎更好。3年后,菌尿复发,膀胱导尿需求增加一倍。死亡率增加与治疗无关。应研究更多老年菌尿患者以评估活动能力和死亡率问题。

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