Scand J Infect Dis. 1991;23(2):213-20. doi: 10.3109/00365549109023403.
The efficiency of treatment of acute urinary tract infections with sulfamethizole for 3 days, sulfamethizole for 10 days, and pivmecillinam for 3 days was compared in a randomized multicentre study comprising 264 girls aged 1-15 years. For ethical reasons children with complicated diseases were not included. In these treatment groups no significant growth after treatment was found in 81%, 77%, and 74%, respectively (NS). New bacteria after treatment were found less frequently after sulfamethizole for 3 days (4%) when compared to sulfamethizole for 10 days (14%) and pivmecillinam for 3 days (13%) (p = 0.048). After pivmecillinam treatment 75% of new bacteria were Streptococcus faecalis versus 25% after sulfamethizole for 3 days and 18% after sulfamethizole for 10 days (p = 0.016). In the subgroup with nephro-urological abnormalities no significant growth after treatment was found in 68% of the sulfamethizole 3-day treated group, 54% of the sulfamethizole 10-day treated group, and 67% of the pivmecillinam 3-day treated group (NS). All treatments resulted in a change in the bacterial sensitivity pattern when bacteria isolated 1-10 days after treatment was compared to those found before treatment. This was more pronounced after the 10-day treatment when compared to the 3-day treatment. The sensitivity patterns of the bacteria isolated from recurrences were similar to those seen before treatment. After treatment there was no difference in the actuarial percentage recurrence-free curves of the 3 treatment groups. Side effects were rare in the sulfamethizole treated groups, and seen more often in the pivmecillinam treated group. 3-day treatment with sulfamethizole or alternatively pivmecillinam is recommended as first choice for treatment of uncomplicated acute urinary tract infections in girls.
在一项纳入264名1至15岁女孩的随机多中心研究中，比较了磺胺甲噻二唑3天疗法、磺胺甲噻二唑10天疗法和匹美西林3天疗法治疗急性尿路感染的疗效。出于伦理原因，患有复杂疾病的儿童未被纳入研究。在这些治疗组中，治疗后分别有81%、77%和74%未发现显著细菌生长（无统计学差异）。与磺胺甲噻二唑10天疗法（14%）和匹美西林3天疗法（13%）相比，磺胺甲噻二唑3天疗法治疗后发现新细菌的频率更低（4%）（p = 0.048）。匹美西林治疗后，75%的新细菌为粪肠球菌，而磺胺甲噻二唑3天疗法后为25%，磺胺甲噻二唑10天疗法后为18%（p = 0.016）。在患有肾-泌尿系统异常的亚组中，磺胺甲噻二唑3天治疗组68%、磺胺甲噻二唑10天治疗组54%和匹美西林3天治疗组67%治疗后未发现显著细菌生长（无统计学差异）。当将治疗后1至10天分离出的细菌与治疗前发现的细菌进行比较时，所有治疗均导致细菌敏感性模式发生变化。与3天治疗相比，10天治疗后这种变化更为明显。复发时分离出的细菌敏感性模式与治疗前相似。治疗后，3个治疗组的无复发精算百分比曲线没有差异。磺胺甲噻二唑治疗组副作用罕见，而匹美西林治疗组更常见。推荐磺胺甲噻二唑3天疗法或匹美西林作为治疗女孩单纯性急性尿路感染的首选。
