Discipline of General Practice, School of Medicine, 1 Distillery Road, NUI Galway, Ireland.
Br J Gen Pract. 2010 Jul;60(576):511-3. doi: 10.3399/bjgp10X514765.
Recurrent urinary tract infections are often re-infections; therefore, antimicrobial susceptibility test results from a previous episode may guide the empiric therapy in subsequent episodes. This analysis provides predictive values of the antimicrobial susceptibility of previous Escherichia coli isolates for the treatment of re-infections in routine clinical practice. If resistance to ampicillin, trimethoprim, or ciprofloxacin is detected, re-prescription within 3 months is imprudent. Susceptibility to nitrofurantoin, ciprofloxacin, or trimethoprim in a previous sample supports their prescription for a re-infection within 3 months and up to a year. Resistance to nitrofurantoin is low and, once detected, decays relatively quickly. Nitrofurantoin should be considered as a first-line agent for initial and repeat treatment.
复发性尿路感染通常是再感染；因此，来自先前发作的抗菌药物敏感性测试结果可能指导后续发作的经验性治疗。本分析提供了先前分离的大肠埃希菌对抗菌药物敏感性的预测值，以指导常规临床实践中的再感染治疗。如果检测到氨苄西林、甲氧苄啶或环丙沙星耐药，则在 3 个月内重新开这些药物是不明智的。如果先前样本中对呋喃妥因、环丙沙星或甲氧苄啶敏感，则支持在 3 个月内至 1 年内再次感染时开具这些药物。呋喃妥因耐药率较低，一旦检出，耐药性会迅速下降。呋喃妥因应作为初始和重复治疗的一线药物。
