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与抗生素相比,对症治疗在单纯性尿路感染中的作用

Role Of Symptomatic Treatment In Comparison To Antibiotics In Uncomplicated Urinary Tract Infections.

作者信息

Jamil Muhammad Nasir, Farooq Umer, Sultan Babar, Khan Raza Muhammad

机构信息

Department of Urology, Ayub Teaching Hospital, Abbottabad, Pakistan.

King Abdullah Teaching Hospital, Mansehra, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2016 Oct-Dec;28(4):734-737.

PMID:28586607
Abstract

BACKGROUND

Uncomplicated urinary tract infections (UTIs) are the most common bacterial infections among women presenting to primary care causing rapidly increasing strains of resistant bacteria to the growing antibiotic industry. Restricting antibiotics to necessary indications is the only solution. The objectives of the study were to compare the efficacy of symptomatic treatment vs antibiotic in patients with uncomplicated UTI, in terms of individual symptom score, i.e., frequency, urgency, dysuria, supra pubic pain scores and total symptoms scores.

METHODS

A randomized control trial (RCT) in 100 women (15-50 years) with symptoms of urinary frequency, urgency, dysuria and pain supra pubic region, associated with uncomplicated UTI, at Urology department, AMI, Abbottabad. Two treatment strategies were compared in uncomplicated UTI patient). Patients were randomized to antibiotic or symptomatic treatment groups on consecutive non-probability basis (50 in each group) given for 05 days. Efficacy of medications was assessed by comparing pre and post treatment symptom scores along with the post treatment scores of both groups compared to see statistical significance of difference by independent samples t-test.

RESULTS

There was a statistically significant difference in symptoms improvement in both treatment arms of all scores, i.e., p-value=0.000. Whereas only dysuria score was able to show a statistically significance of difference in post Rx scores comparison of both groups, p-value=0.004.

CONCLUSIONS

Symptomatic treatment is not inferior to antibiotic treatment when proper patient selection is undertaken, resulting in decreased need for unnecessary antibiotics use.

摘要

背景

单纯性尿路感染(UTIs)是初级保健中女性最常见的细菌感染,导致对抗生素行业不断增长的耐药菌株迅速增加。将抗生素限制在必要的适应症范围内是唯一的解决办法。本研究的目的是比较单纯性UTI患者对症治疗与抗生素治疗在个体症状评分方面的疗效,即尿频、尿急、尿痛、耻骨上疼痛评分和总症状评分。

方法

在阿伯塔巴德阿米尔医学研究所泌尿外科,对100名年龄在15至50岁、有尿频、尿急、尿痛和耻骨上区疼痛症状且伴有单纯性UTI的女性进行随机对照试验(RCT)。在单纯性UTI患者中比较两种治疗策略。患者按连续非概率原则随机分为抗生素治疗组或对症治疗组(每组50人),治疗5天。通过比较治疗前后的症状评分以及两组的治疗后评分来评估药物疗效,采用独立样本t检验查看差异的统计学意义。

结果

所有评分的两个治疗组在症状改善方面均有统计学显著差异,即p值 = 0.000。而只有尿痛评分在两组治疗后评分比较中显示出统计学显著差异,p值 = 0.004。

结论

在进行适当的患者选择时,对症治疗并不逊色于抗生素治疗,从而减少了不必要使用抗生素的需求。

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