Jodal U, Larsson P, Hansson S, Bauer C A
Department of Paediatrics, Gothenburg University, Göteborg, Sweden.
Scand J Infect Dis. 1989;21(3):299-302. doi: 10.3109/00365548909035699.
Pivmecillinam in a single bed-time dose of 5-10 mg/kg was given as long-term prophylaxis to 20 girls with recurrent bacteriuria for a total of 228 months. Symptomatic recurrences occurred in 4 girls, i.e. 1.8 infections/100 months as compared to 17/100 months during the year preceding the study. The frequency of positive urine cultures during prophylaxis was 11%. 10 of the 15 isolates were enterococci, resistant to mecillinam. In rectal swabs examined for the presence of aerobic gram-negative bacteria, enterobacteria were isolated in 78% with a low rate of resistance to mecillinam (11%). Thus pivmecillinam offered effective protection against recurrent urinary tract infections, and did not tend to select resistant enterobacteria in the bowel, but allowed resistant enterococci to cause a few symptomatic infections.
对20名复发性菌尿症女童采用单剂量5 - 10mg/kg的匹美西林睡前用药进行长期预防，共治疗228个月。4名女童出现症状复发，即1.8次感染/100个月，而在研究前一年为17次/100个月。预防期间尿培养阳性频率为11%。15株分离菌中有10株为对匹美西林耐药的肠球菌。在检测需氧革兰氏阴性菌的直肠拭子中，78%分离出肠杆菌，对匹美西林耐药率较低（11%）。因此，匹美西林可有效预防复发性尿路感染，且不会在肠道中倾向于选择耐药肠杆菌，但会使耐药肠球菌引发少数有症状感染。
