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。
相似文献
1
Treatment duration of febrile urinary tract infections.
Curr Infect Dis Rep. 2011 Dec;13(6):571-8. doi: 10.1007/s11908-011-0211-y.
2
Risk factors for fluoroquinolone-resistant Escherichia coli in adults with community-onset febrile urinary tract infection.
J Antimicrob Chemother. 2011 Mar;66(3):650-6. doi: 10.1093/jac/dkq465. Epub 2010 Dec 1.
3
Fluoroquinolones in the treatment of acute uncomplicated urinary tract infections in adult women.
Expert Opin Pharmacother. 2001 Aug;2(8):1227-37. doi: 10.1517/14656566.2.8.1227.
4
Lactobacilli vs antibiotics to prevent urinary tract infections: a randomized, double-blind, noninferiority trial in postmenopausal women.
Arch Intern Med. 2012 May 14;172(9):704-12. doi: 10.1001/archinternmed.2012.777.
5
Fluoroquinolones and resistance in the treatment of uncomplicated urinary tract infection.
Int J Antimicrob Agents. 2003 Oct;22 Suppl 2:65-72. doi: 10.1016/s0924-8579(03)00238-3.
6
Diagnosis and treatment of urinary tract infections across age groups.
Am J Obstet Gynecol. 2018 Jul;219(1):40-51. doi: 10.1016/j.ajog.2017.12.231. Epub 2018 Jan 2.
7
The role of fluoroquinolones in the management of urinary tract infections in areas with high rates of fluoroquinolone-resistant uropathogens.
Eur J Clin Microbiol Infect Dis. 2012 Aug;31(8):1699-704. doi: 10.1007/s10096-011-1457-x. Epub 2011 Nov 4.
8
Antimicrobial agents for treating uncomplicated urinary tract infection in women.
Cochrane Database Syst Rev. 2010 Oct 6(10):CD007182. doi: 10.1002/14651858.CD007182.pub2.
9
Use of administrative healthcare claims to examine the effectiveness of trimethoprim-sulfamethoxazole versus fluoroquinolones in the treatment of community-acquired acute pyelonephritis in women.
J Antimicrob Chemother. 2004 Mar;53(3):512-7. doi: 10.1093/jac/dkh100. Epub 2004 Jan 28.
10
Quinolone, fluoroquinolone and trimethoprim/sulfamethoxazole resistance in relation to virulence determinants and phylogenetic background among uropathogenic Escherichia coli.
J Antimicrob Chemother. 2006 Feb;57(2):204-11. doi: 10.1093/jac/dki468. Epub 2006 Jan 3.
引用本文的文献
1
External validation of a clinical prediction rule on the need for radiologic imaging to identify urological disorders in adult patients with febrile urinary tract infections.
Singapore Med J. 2022 Mar;63(3):167-169. doi: 10.11622/smedj.2022047.
2
No Clinical Benefit to Treating Male Urinary Tract Infection Longer Than Seven Days: An Outpatient Database Study.
Open Forum Infect Dis. 2019 May 6;6(6):ofz216. doi: 10.1093/ofid/ofz216. eCollection 2019 Jun.
3
Stopping the effective non-fluoroquinolone antibiotics at day 7 vs continuing until day 14 in adults with acute pyelonephritis requiring hospitalization: A randomized non-inferiority trial.
PLoS One. 2018 May 16;13(5):e0197302. doi: 10.1371/journal.pone.0197302. eCollection 2018.
4
Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women-A double-blind, randomized non-inferiority trial.
PLoS Med. 2018 May 15;15(5):e1002569. doi: 10.1371/journal.pmed.1002569. eCollection 2018 May.
5
Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections.
Infect Chemother. 2018 Mar;50(1):67-100. doi: 10.3947/ic.2018.50.1.67.
6
Treatment duration of febrile urinary tract infection: a pragmatic randomized, double-blind, placebo-controlled non-inferiority trial in men and women.
BMC Med. 2017 Apr 3;15(1):70. doi: 10.1186/s12916-017-0835-3.
7
Differential characteristics of healthcare-associated compared to community-acquired febrile urinary tract infections in males.
Eur J Clin Microbiol Infect Dis. 2015 Dec;34(12):2395-402. doi: 10.1007/s10096-015-2493-8. Epub 2015 Sep 25.
本文引用的文献
1
International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases.
Clin Infect Dis. 2011 Mar 1;52(5):e103-20. doi: 10.1093/cid/ciq257.
2
Prospective cohort study of acute pyelonephritis in adults: safety of triage towards home based oral antimicrobial treatment.
J Infect. 2010 Feb;60(2):114-21. doi: 10.1016/j.jinf.2009.11.008. Epub 2009 Nov 27.
3
Treatment duration of febrile urinary tract infection (FUTIRST trial): a randomized placebo-controlled multicenter trial comparing short (7 days) antibiotic treatment with conventional treatment (14 days).
BMC Infect Dis. 2009 Aug 19;9:131. doi: 10.1186/1471-2334-9-131.
4
ACOG Practice Bulletin No. 91: Treatment of urinary tract infections in nonpregnant women.
Obstet Gynecol. 2008 Mar;111(3):785-94. doi: 10.1097/AOG.0b013e318169f6ef.
5
A double-blind, randomized comparison of levofloxacin 750 mg once-daily for five days with ciprofloxacin 400/500 mg twice-daily for 10 days for the treatment of complicated urinary tract infections and acute pyelonephritis.
Urology. 2008 Jan;71(1):17-22. doi: 10.1016/j.urology.2007.09.002.
6
Short-term therapy for urinary tract infection: success and failure.
Int J Antimicrob Agents. 2008 Feb;31 Suppl 1:S40-5. doi: 10.1016/j.ijantimicag.2007.07.040. Epub 2007 Nov 26.
7
A trial of levofloxacin 750 mg once daily for 5 days versus ciprofloxacin 400 mg and/or 500 mg twice daily for 10 days in the treatment of acute pyelonephritis.
Curr Med Res Opin. 2007 Nov;23(11):2637-45. doi: 10.1185/030079907x233340.
8
Antibiotic resistance and pyelonephritis.
Clin Infect Dis. 2007 Aug 1;45(3):281-3. doi: 10.1086/519267. Epub 2007 Jun 19.
9
Fluoroquinolone use is the predominant risk factor for the development of a new strain of clostridium difficile-associated disease.
BJU Int. 2007 Jun;99(6):1333-4. doi: 10.1111/j.1464-410X.2006.06741.x. Epub 2007 Jan 16.
10
A hospital outbreak of diarrhea due to an emerging epidemic strain of Clostridium difficile.
Arch Intern Med. 2006;166(22):2518-24. doi: 10.1001/archinte.166.22.2518.
Zotero 插件