Bruyère F, Dihn A, Sotto A
Service d'urologie, CHRU de Tours, Tours, France; Université François-Rabelais de Tours, PRES ; Centre Val de Loire Université, 37000 Tours, France.
Unité des maladies infectieuses, hôpital universitaire Paris Île-de-France Ouest, Garches, AP-HP, Paris, France.
Prog Urol. 2016 Jun;26(8):437-41. doi: 10.1016/j.purol.2016.05.002. Epub 2016 Jun 22.
This is a review article aiming to bring the place and manner of use of amoxicillin-clavulanic acid in urology.
Data collection on the conditions of use of amoxicillin-clavulanic acid in urology has been performed from the Medline database. The following keywords were used: amoxicillin; clavulanic acid; urine; diffusion; pharmacokinetics. The selection was based on the methodology, language of publication (English/French), relevance to the topic and date of publication of the articles collected.
Overall, it is clear from the literature and the national and international guidelines that amoxicillin-clavulanic acid in urinary infections can not be used in probabilistic. However, this association remains valid excepted in the treatment of male urinary tract infections due to a probable fault prostatic diffusion. Note that changing the critical concentrations by the CA-SFM/EUCAST for cystitis of this association should allow an extension of its indication in this situation. Serious adverse effects of amoxicillin-clavulanic acid remain rare.
If long, the amoxicillin-clavulanic acid played a role of first order in the field of urology, the association has given way to other molecules because of the emergence of resistance. However, A-AC keeps indications in the field of antibiotic therapy in urinary tract infections, surgical antimicrobial prophylaxis and postoperative infections in urology.
本文是一篇综述文章，旨在阐述阿莫西林 - 克拉维酸在泌尿外科的应用地位及使用方式。
从Medline数据库收集阿莫西林 - 克拉维酸在泌尿外科使用情况的数据。使用了以下关键词：阿莫西林；克拉维酸；尿液；扩散；药代动力学。选择基于所收集文章的方法、发表语言（英语/法语）、与主题的相关性及发表日期。
总体而言，从文献以及国家和国际指南中可以明确看出，阿莫西林 - 克拉维酸在泌尿系统感染中不能凭经验使用。然而，除了因可能存在前列腺扩散问题而治疗男性尿路感染外，这种联合用药仍然有效。注意，欧洲抗菌药物敏感性试验委员会/欧洲药敏试验委员会（CA - SFM/EUCAST）改变该联合用药治疗膀胱炎的临界浓度，应会扩大其在这种情况下的适应证。阿莫西林 - 克拉维酸的严重不良反应仍然罕见。
尽管阿莫西林 - 克拉维酸在泌尿外科领域曾长期发挥一线作用，但由于耐药性的出现，这种联合用药已被其他分子所取代。然而，阿莫西林 - 克拉维酸在泌尿系统感染的抗生素治疗、外科抗菌预防及泌尿外科术后感染领域仍有适应证。
