Brumpt I
Laboratoire Roger Bellon, Neuilly-sur-Seine.
Rev Prat. 1990 May 11;40(14):1271-4.
Some twenty years ago, its was generally agreed that bacterial cystitis should be treated for 7 to 10 days, but since that time numerous clinical studies have suggested that shorter, single-dose or three-day treatments were possible. The single-dose chemotherapy of bacterial cystitis in women is a new and different approach with several prerequisites: strict clinical indication; use of a microbiologically and pharmacokinetically appropriate agent whose effectiveness has been demonstrated by clinical trials; close clinical and microbiological follow-up after treatment. Amoxicillin, aminoglycosides and above all drugs with prolonged urinary excretion, such as trimethoprim-sulfamethoxazole and notably fluoroquinolones (including pefloxacine), have proved to be effective as single-dose treatment of bacterial cystitis in women. In patients whose cystitis relapses at very short intervals, continuous or intermittent low-dose antibacterial prophylaxis may be contemplated, using trimethoprim-sulfamethoxazole, nitrofurantoin, trimethoprim alone or a quinolone. American authors have suggested, in some special cases, a patient-administered single-dose therapy at home as soon as the first signs of relapse appear.
大约二十年前,人们普遍认为细菌性膀胱炎应治疗7至10天,但自那时以来,大量临床研究表明,更短疗程的单剂量或三日疗法也是可行的。女性细菌性膀胱炎的单剂量化疗是一种全新且不同的方法,有几个前提条件:严格的临床指征;使用一种经临床试验证明有效的、在微生物学和药代动力学方面合适的药物;治疗后密切的临床和微生物学随访。阿莫西林、氨基糖苷类药物,尤其是具有较长尿液排泄时间的药物,如甲氧苄啶-磺胺甲恶唑,特别是氟喹诺酮类药物(包括培氟沙星),已被证明作为女性细菌性膀胱炎的单剂量治疗是有效的。对于膀胱炎复发间隔非常短的患者,可以考虑使用甲氧苄啶-磺胺甲恶唑、呋喃妥因、单独使用甲氧苄啶或喹诺酮进行连续或间歇性低剂量抗菌预防。美国作者建议,在某些特殊情况下,一旦出现复发的最初迹象,患者可在家自行进行单剂量治疗。