Robinson Joan L, Le Saux Nicole
a Department of Pediatrics , Stollery Children's Hospital and University of Alberta , Edmonton , Canada.
b Department of Pediatrics , Children's Hospital of Eastern Ontario and University of Ottawa , Ottawa , Canada.
Expert Rev Anti Infect Ther. 2016 Sep;14(9):809-16. doi: 10.1080/14787210.2016.1206816. Epub 2016 Jul 25.
Accurate diagnosis and appropriate use of antimicrobials for treatment and prevention of urinary tract infections (UTIs) is vital in an era of increasing antibiotic resistance.
The article reviews indications for and interpretation of urinalysis and urine culture results for diagnosis of UTI, choice of antibiotics for empiric and definitive UTI therapy, the rationale behind and indications for radiographic investigations, and prevention of UTIs including the complex decision as to whether antibiotic prophylaxis will benefit a child. Expert commentary: Over-diagnosis of UTI is a prevalent problem due to the lack of specificity of both urinalysis and urine culture. The most major recent advance in the field has been the recognition that antibiotic prophylaxis for UTI is rarely indicated as in most situations, the number needed to treat to prevent one UTI is too high to justify the risk of adverse events and development of antimicrobial resistance.
在抗生素耐药性不断增加的时代，准确诊断并合理使用抗菌药物来治疗和预防尿路感染（UTIs）至关重要。
本文回顾了用于诊断UTI的尿液分析和尿培养结果的指征及解读、经验性和确定性UTI治疗的抗生素选择、影像学检查的依据和指征，以及UTIs的预防，包括关于抗生素预防是否对儿童有益这一复杂决策。专家评论：由于尿液分析和尿培养缺乏特异性，UTI的过度诊断是一个普遍问题。该领域最近最主要的进展是认识到UTI很少需要进行抗生素预防，因为在大多数情况下，预防一例UTI所需治疗的人数过高，以至于无法证明承担不良事件和产生抗菌药物耐药性风险的合理性。
