发热性尿路感染的治疗持续时间。
Treatment duration of febrile urinary tract infections.
机构信息
Department of Infectious Diseases, Leiden University Medical Center, Postbox 9600, 2300 RC, Leiden, the Netherlands,
出版信息
Curr Infect Dis Rep. 2011 Dec;13(6):571-8. doi: 10.1007/s11908-011-0211-y.
Abstract
Although febrile urinary tract infections (UTIs) are relatively common in adults, data on optimal treatment duration are limited. Randomized controlled trials specifically addressing the elderly and patients with comorbidities have not been performed. This review highlights current available evidence. Premenopausal, non-pregnant women without comorbidities can be treated with a 5-7 day regimen of fluoroquinolones in countries with low levels of fluoroquinolone resistance, or, if proven susceptible, with 14 days of trimethoprim-sulfamethoxazole. Oral β-lactams are less effective compared with fluoroquinolones and trimethoprim-sulfamethoxazole. In men with mild to moderate febrile UTI, a 2-week regimen of an oral fluoroquinolone is likely sufficient. Although data are limited, this possibly holds even in the elderly patients with comorbidities or bacteremia.
摘要
虽然发热性尿路感染（UTI）在成年人中相对常见，但关于最佳治疗持续时间的数据有限。尚未进行专门针对老年人和合并症患者的随机对照试验。本综述强调了当前可用的证据。在氟喹诺酮类药物耐药率较低的国家，没有合并症的绝经前、非妊娠女性可以用 5-7 天氟喹诺酮类药物治疗，或者如果证实敏感，可以用 14 天复方磺胺甲噁唑治疗。口服β-内酰胺类药物的疗效不如氟喹诺酮类药物和复方磺胺甲噁唑。对于轻度至中度发热性 UTI 的男性，口服氟喹诺酮类药物 2 周的疗程可能就足够了。尽管数据有限，但即使在有合并症或菌血症的老年患者中，这种情况也可能存在。
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