Ronald A R, Jagdis F A, Harding G K, Hoban S A, Miur P L, Gurwith M J
Antimicrob Agents Chemother. 1977 May;11(5):780-4. doi: 10.1128/AAC.11.5.780.
Fifty-two patients, 48 females and 4 males, with suspected urinary infection were treated with amoxicillin. Twenty-two females with presumed bladder infection were treated with amoxicillin, 250 mg three times a day for 7 days; 26 females and 4 males with presumed renal infection were treated with amoxicillin, 500 mg three times a day for 14 days. Five patients were immediate treatment failures, with positive urine cultures during therapy. All five patients had been infected with amoxicillin-resistant urinary pathogens. Three patients, treated as for bladder infections, reinfected during 6 weeks of follow-up, and only one relapsed. Two patients, treated as for renal infections, reinfected, whereas four relapsed. During therapy, amoxicillin-susceptible gram-negative rods were eradicated from the periurethral area in all but one patient. Of 28 patients studied, 19 acquired a predominant growth of either resistant aerobic gram-negative rods or Candida albicans from periurethral cultures. Our findings suggest that these two regimens of amoxicillin achieve satisfactory cure rates in urinary infection, but both regimens significantly alter the normal periurethral flora.
52例疑似尿路感染患者（48例女性，4例男性）接受了阿莫西林治疗。22例推测为膀胱感染的女性患者接受了阿莫西林治疗，剂量为250毫克，每日3次，共7天；26例女性和4例男性推测为肾脏感染，接受了阿莫西林治疗，剂量为500毫克，每日3次，共14天。5例患者治疗立即失败，治疗期间尿培养呈阳性。所有5例患者均感染了对阿莫西林耐药的尿路病原体。3例按膀胱感染治疗的患者在6周随访期间再次感染，仅1例复发。2例按肾脏感染治疗的患者再次感染，4例复发。治疗期间，除1例患者外，所有患者尿道周围区域的阿莫西林敏感革兰氏阴性杆菌均被根除。在研究的28例患者中，19例患者尿道周围培养物中出现了耐药需氧革兰氏阴性杆菌或白色念珠菌的优势生长。我们的研究结果表明，这两种阿莫西林治疗方案在尿路感染中可达到令人满意的治愈率，但两种方案均会显著改变尿道周围的正常菌群。
