无尿血液透析患者复发性尿路感染的治疗，我们真的需要抗菌药物在尿液中达到有效浓度吗？
Treatment of recurrent urinary tract infections in anuric hemodialysis patient, do we really need antimicrobial urinary concentration?
作者信息
El Nekidy Wasim S, Soong Derrick, Mooty Mohamad, Ghazi Islam M
机构信息
Cleveland Clinic, Abu Dhabi, United Arab Emirates and Cleveland Clinic Lerner College of Medicine, Case Western University, Cleveland, OH, USA.
Windsor Regional Hospital, Windsor, ON, Canada.
出版信息
IDCases. 2020 Mar 21;20:e00748. doi: 10.1016/j.idcr.2020.e00748. eCollection 2020.
Abstract
Providing care for patients with chronic kidney disease requires considerations that are unique to this population. Several references recommend the treating urinary tract infections with antibiotics that achieve considerable concentrations in urine however this is not applicable in anuric patients undergoing hemodialysis who are unable to excrete antibiotics significantly in urine. We report successful treatment of several episodes of urinary tract infections in hemodialysis patient highlighting the questionable need for antimicrobial urine concentration.
摘要
为慢性肾病患者提供护理需要考虑该人群特有的因素。一些参考文献建议使用在尿液中能达到较高浓度的抗生素来治疗尿路感染，然而这并不适用于正在接受血液透析且无尿的患者，因为他们无法在尿液中大量排泄抗生素。我们报告了对一名血液透析患者多次尿路感染的成功治疗，突出了对抗菌药物尿液浓度需求的存疑之处。
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本文引用的文献
1
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Antimicrob Agents Chemother. 2019 Sep 9;63(12). doi: 10.1128/AAC.01427-19. Epub 2019 Sep 16.
2
Salvage of Hemodialysis Catheter in Staphylococcal Bacteremia: Case Series, Revisiting the Literature, and the Role of the Pharmacist.金黄色葡萄球菌菌血症中血液透析导管的挽救：病例系列、文献回顾及药师的作用
Case Rep Nephrol Dial. 2018 Jul 25;8(2):121-129. doi: 10.1159/000489923. eCollection 2018 May-Aug.
3
Pharmacokinetics and investigation of optimal dose ertapenem in intermittent hemodialysis patients.药代动力学和最佳剂量厄他培南在间歇性血液透析患者中的研究。
Nephrol Dial Transplant. 2019 Oct 1;34(10):1766-1772. doi: 10.1093/ndt/gfy166.
4
Successful treatment of multidrug resistant using dual carbapenem regimen in immunocompromised patient.在免疫功能低下患者中使用双碳青霉烯类方案成功治疗多重耐药菌感染。
IDCases. 2017 Jun 15;9:53-55. doi: 10.1016/j.idcr.2017.06.005. eCollection 2017.
5
Predicting Maintenance Doses of Vancomycin for Hospitalized Patients Undergoing Hemodialysis.预测接受血液透析的住院患者万古霉素的维持剂量。
Can J Hosp Pharm. 2016 Sep-Oct;69(5):341-347. doi: 10.4212/cjhp.v69i5.1588. Epub 2016 Oct 31.
6
A practical thrice weekly Ertapenem dosage regime for chronic hemodialysis patients?一种适用于慢性血液透析患者的每周三次厄他培南实用给药方案？
Clin Nephrol. 2013 Oct;80(4):312. doi: 10.5414/cn108071.
7
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Can J Hosp Pharm. 2012 Nov;65(6):436-42. doi: 10.4212/cjhp.v65i6.1191.
8
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Hemodial Int. 2013 Jul;17(3):434-40. doi: 10.1111/hdi.12004. Epub 2012 Nov 26.
9
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Infect Dis Clin North Am. 2009 Dec;23(4):899-924, viii. doi: 10.1016/j.idc.2009.06.009.
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