Wang Alina, Nizran Parminder, Malone Michael A, Riley Timothy
Penn State Department of Family and Community Medicine, Hershey, PA, USA.
Prim Care. 2013 Sep;40(3):687-706. doi: 10.1016/j.pop.2013.06.005. Epub 2013 Jul 12.
Clinical presentation helps differentiate between upper and lower urinary tract infections (UTIs). UTIs are classified as either complicated or uncomplicated. A complicated UTI is associated with an underlying condition that increases the risk of failing therapy. Primary laboratory tests for UTIs consist of urinalysis and urine culture. The most common pathogen for uncomplicated cystitis and pyelonephritis is Escherichia coli. Nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole are first-line therapies for acute uncomplicated cystitis. Decisions regarding antibiotic agents should be individualized based on patients' allergies, tolerability, community resistance rates, cost, and availability.
临床表现有助于区分上尿路感染和下尿路感染(UTIs)。UTIs分为复杂性和非复杂性两类。复杂性UTI与一种会增加治疗失败风险的潜在疾病相关。UTIs的主要实验室检查包括尿液分析和尿培养。非复杂性膀胱炎和肾盂肾炎最常见的病原体是大肠杆菌。呋喃妥因、磷霉素和甲氧苄啶-磺胺甲恶唑是急性非复杂性膀胱炎的一线治疗药物。关于抗生素的选择应根据患者的过敏情况、耐受性、社区耐药率、成本和可获得性进行个体化决策。