Tan J S, File T M
Infectious Disease Section, Northeastern Ohio Universities College of Medicine, Akron 44304.
J Reprod Med. 1990 Mar;35(3 Suppl):339-42.
Escherichia coli is still the most common bacterial pathogen associated with urinary tract infections in women. Because of increasing resistance, ampicillin or a sulfonamide alone is no longer recommended for the empiric treatment of those infections. Antimicrobial therapy that contains a beta-lactamase inhibitor or that is resistant to the action of beta-lactamase is preferred. For the treatment of acute, uncomplicated lower urinary tract infection in a young woman, a short course of therapy (single dose) may be adequate. For an upper tract or complicated infection a longer course of therapy is advised. Asymptomatic bacteriuria in pregnancy should be treated; a short course of therapy with a beta-lactam antibiotic may be tried only if posttherapy follow-up cultures are planned. When bacteriuria persists or recurs, a longer course of therapy should follow, with consideration given to a urologic workup after delivery.
大肠杆菌仍然是与女性尿路感染相关的最常见细菌病原体。由于耐药性增加，不再推荐单独使用氨苄西林或磺胺类药物对这些感染进行经验性治疗。含有β-内酰胺酶抑制剂或对β-内酰胺酶作用具有抗性的抗菌疗法是首选。对于年轻女性急性、非复杂性下尿路感染的治疗，短疗程（单剂量）治疗可能就足够了。对于上尿路或复杂性感染，建议采用更长疗程的治疗。妊娠期间的无症状菌尿应予以治疗；只有在计划进行治疗后随访培养时，才可以尝试使用β-内酰胺抗生素进行短疗程治疗。当菌尿持续或复发时，应采用更长疗程的治疗，并考虑在分娩后进行泌尿外科检查。
