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[尿路感染的合理抗生素治疗]

[Rational antibiotic therapy of urinary tract infections].

作者信息

Wagenlehner Florian M E, Naber Kurt G, Weidner Wolfgang

机构信息

Klinik und Poliklinik für Urologie und Kinderurologie, Justus-Liebig-Universität Giessen, Rudolf-Buchheim-Str. 7, 35385 Giessen.

出版信息

Med Monatsschr Pharm. 2008 Oct;31(10):385-90; quiz 391-2.

Abstract

Rational antibiotic therapy of urinary tract infections Urinary tract infections (UTI) are frequent infections in the outpatient and nosocomial setting. Generally UTI can be stratified into uncomplicated and complicated infections with respect to treatment options. Uncomplicated UTI are mainly caused by E. coli, whereas complicated UTI exhibit a broader bacterial spectrum with a higher rate of multiresistant uropathogens. On the other hand increasing resistance rates are also found in uncomplicated UTI, e.g. against aminopenicillins, Co-trimoxazol and increasingly also fluoroquinolones. This fact has to be considered in the empirical therapy. Recurrent UTI are frequently found in young, sexually active women, and postmenopausal women. In complicated UTI the complicating factors have to be diagnosed and treated additionally to the antibiotic treatment. If not treated, a severe UTI and urosepsis can develop.

摘要

泌尿道感染的合理抗生素治疗 泌尿道感染(UTI)是门诊和医院环境中常见的感染。一般而言,就治疗方案而言,UTI可分为单纯性感染和复杂性感染。单纯性UTI主要由大肠杆菌引起,而复杂性UTI的细菌谱更广,多重耐药尿路病原体的发生率更高。另一方面,在单纯性UTI中也发现耐药率不断上升,例如对氨基青霉素、复方新诺明以及越来越多的氟喹诺酮类药物。在经验性治疗中必须考虑这一事实。复发性UTI常见于年轻、性活跃的女性以及绝经后女性。在复杂性UTI中,除了抗生素治疗外,还必须诊断和治疗复杂因素。如果不进行治疗,可能会发展为严重的UTI和尿脓毒症。

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