Mospan Geoffrey A, Wargo Kurt A
From the Wingate University School of Pharmacy, Hendersonville, NC.
J Am Board Fam Med. 2016 Nov 12;29(6):654-662. doi: 10.3122/jabfm.2016.06.160065.
Current guidelines classify urinary tract infections (UTIs) in males as complicated and recommend longer treatment than for UTIs in females. The objective of this study is to demonstrate that males with UTIs may be successfully treated with an outpatient 5-day course of levofloxacin.
Data were obtained from a previously conducted clinical trial (www.clinicaltrials.gov identifier NCT00210886), a multicenter, double-blind, randomized, noninferiority study comparing levofloxacin 750 mg intravenously/by mouth once daily for 5 days and ciprofloxacin 400/500 mg intravenously/by mouth twice daily for 10 days in complicated UTI (cUTI). The current study was a post hoc, subgroup analysis of male and female subjects with cUTI. Subjects were stratified into groups based on sex and antibiotic received. The subjects were analyzed at the end of therapy (EOT) and post therapy (PT) for clinical success rates, defined as no further need for antimicrobial treatment.
Totals of 427 patients (224 male, 203 female) and 350 patients (189 male, 161 female) were included in the modified intent-to-treat (mITT) population and microbiologically evaluable (ME) populations, respectively. Clinical success rates between males and females were not statistically different between antibiotic groups in either the mITT or ME populations at EOT or PT.
This study demonstrates that males with UTI may be treated with a shorter course of antimicrobial therapy for UTI than previously recommended.
当前指南将男性尿路感染(UTIs)归类为复杂性感染,并建议采用比女性尿路感染更长的治疗疗程。本研究的目的是证明男性尿路感染患者可通过门诊口服左氧氟沙星5天疗程成功治愈。
分别有427例患者(224例男性,203例女性)和350例患者(189例男性,161例女性)被纳入改良意向性治疗(mITT)人群和微生物学可评估(ME)人群。在EOT或PT时,mITT人群或ME人群中,各抗生素组的男性和女性临床成功率在统计学上无差异。
本研究表明,男性尿路感染患者接受的尿路感染抗菌治疗疗程可能比之前推荐的疗程更短。