Falagas Matthew E, Kotsantis Ioannis K, Vouloumanou Evridiki K, Rafailidis Petros I
Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.
J Infect. 2009 Feb;58(2):91-102. doi: 10.1016/j.jinf.2008.12.009. Epub 2009 Feb 4.
Acute uncomplicated cystitis is one of the most common bacterial infections in women and is conventionally treated with antibiotics. However, emergence of resistant uropathogens forces physicians to reconsider the prescription of antibiotics for acute uncomplicated cystitis in non-pregnant young women.
To evaluate the effectiveness of antibiotics in the treatment of acute uncomplicated cystitis.
We searched PubMed, the Cochrane Central Register of Controlled Trials and Scopus database.
Five randomized controlled trials (RCTs) involving non-pregnant, non-immunocompromised adult women with clinically and microbiologically documented acute uncomplicated cystitis were included. Clinical success was significantly more likely in women treated with antibiotics versus those treated with placebo [4 RCTs, 1062 patients, random effects model (REM), odds ratio (OR)=4.81, 95% confidence intervals (CI)=2.51-9.21]. Antibiotics were also superior to placebo, regarding cure (4 RCTs, 1062 patients, REM, OR=4.67, 95%CI=2.34-9.35); microbiological eradication at the end of treatment (3 RCTs, 967 patients, REM, OR=10.67, 95%CI=2.96-38.43); after the end of treatment (3 RCTs, 738 patients, REM, OR=5.38, 95%CI=1.63-17.77), and microbiological reinfection or relapse (5 RCTs, 843 patients, REM, OR=0.27, 95%CI=0.13-0.55). However, adverse events were more likely to occur in antibiotic-treated patients versus placebo-treated women (4 RCTs, 1068 patients, REM, OR=1.64, 95%CI=1.10-2.44). No difference was found between the compared treatment arms regarding study withdrawals from adverse events, the development of pyelonephritis and emergence of resistance.
Antibiotics are superior to placebo regarding both clinical and microbiological success in adult non-pregnant women with microbiologically confirmed acute uncomplicated cystitis. However, they are associated with more adverse events.
急性单纯性膀胱炎是女性最常见的细菌感染之一，传统上用抗生素治疗。然而，耐药尿路病原体的出现迫使医生重新考虑对非妊娠年轻女性急性单纯性膀胱炎的抗生素处方。
评估抗生素治疗急性单纯性膀胱炎的有效性。
我们检索了PubMed、Cochrane对照试验中央注册库和Scopus数据库。
纳入了五项随机对照试验（RCT），涉及非妊娠、非免疫功能低下的成年女性，她们患有临床和微生物学记录的急性单纯性膀胱炎。与接受安慰剂治疗的女性相比，接受抗生素治疗的女性临床成功的可能性显著更高[4项RCT，1062例患者，随机效应模型（REM），优势比（OR）=4.81，95%置信区间（CI）=2.51-9.21]。在治愈率方面，抗生素也优于安慰剂（4项RCT，1062例患者，REM，OR=4.67，95%CI=2.34-9.35）；治疗结束时的微生物清除率（3项RCT，967例患者，REM，OR=10.67，95%CI=2.96-38.43）；治疗结束后（3项RCT，738例患者，REM，OR=5.38，95%CI=1.63-17.77），以及微生物再感染或复发率（5项RCT，843例患者，REM，OR=0.27，95%CI=0.13-0.55）。然而，与接受安慰剂治疗的女性相比，接受抗生素治疗的患者更易发生不良事件（4项RCT，1068例患者，REM，OR=1.64，95%CI=1.10-2.44）。在因不良事件退出研究、肾盂肾炎的发生和耐药性的出现方面，比较的治疗组之间未发现差异。
对于微生物学确诊的急性单纯性膀胱炎的成年非妊娠女性，抗生素在临床和微生物学成功方面优于安慰剂。然而，它们与更多的不良事件相关。
Zotero 插件