Malinverni R, Glauser M P
Medizinische Universitätsklinik, Inselspital, Bern, Switzerland.
Rev Infect Dis. 1988 Jan-Feb;10 Suppl 1:S153-63. doi: 10.1093/clinids/10.supplement_1.s153.
The results of comparative trials of fluoroquinolones for the treatment of uncomplicated and complicated urinary tract infections (UTI) were reviewed. Several randomized, comparative trials showed that in uncomplicated UTI norfloxacin, ciprofloxacin, and ofloxacin were at least as effective as trimethoprim-sulfamethoxazole (TMP-SMZ) and amoxicillin and usually more effective than nalidixic acid, pipemidic acid, and nitrofurantoin. Comparative trials of single-dose regimens have, however, been limited. A few randomized, comparative trials have shown that in complicated UTI norfloxacin, ciprofloxacin, and ofloxacin were at least as effective as amoxicillin and TMP-SMZ and usually more effective than pipemidic acid. Moreover, preliminary results indicate that fluoroquinolones might be effective for the oral treatment of complicated UTI that are difficult to treat, especially those due to Pseudomonas aeruginosa. Comparative trials are needed to establish the value of fluoroquinolones for chronic bacterial prostatitis. There are no conclusive data on fluoroquinolone treatment of UTI in patients with renal failure. Emergence of resistant pathogens during therapy with fluoroquinolones has been infrequent but might be more frequent in complicated UTI caused by P. aeruginosa.
对氟喹诺酮类药物治疗单纯性和复杂性尿路感染（UTI）的比较试验结果进行了综述。多项随机对照试验表明，在单纯性UTI中，诺氟沙星、环丙沙星和氧氟沙星至少与甲氧苄啶-磺胺甲恶唑（TMP-SMZ）及阿莫西林疗效相当，且通常比萘啶酸、吡哌酸和呋喃妥因更有效。然而，单剂量方案的比较试验有限。一些随机对照试验表明，在复杂性UTI中，诺氟沙星、环丙沙星和氧氟沙星至少与阿莫西林及TMP-SMZ疗效相当，且通常比吡哌酸更有效。此外，初步结果表明，氟喹诺酮类药物可能对难以治疗的复杂性UTI的口服治疗有效，尤其是由铜绿假单胞菌引起的UTI。需要进行比较试验来确定氟喹诺酮类药物对慢性细菌性前列腺炎的价值。关于氟喹诺酮类药物治疗肾衰竭患者UTI尚无确凿数据。氟喹诺酮类药物治疗期间耐药病原体的出现并不常见，但在由铜绿假单胞菌引起的复杂性UTI中可能更常见。
