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呋喃妥因治疗女性单纯性尿路感染:给药方案、年龄和肾功能对药物暴露的影响。

Nitrofurantoin for the treatment of uncomplicated urinary tract infection in female patients: the impact of dosing regimen, age, and renal function on drug exposure.

机构信息

Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Dr. Molewaterplein 40, 3015, Rotterdam, The Netherlands.

Department of Medical Microbiology, Haaglanden Medisch Centrum, The Hague, The Netherlands.

出版信息

Eur J Clin Pharmacol. 2023 Aug;79(8):1043-1049. doi: 10.1007/s00228-023-03507-2. Epub 2023 Jun 2.

Abstract

PURPOSE

The aim of this study is to determine nitrofurantoin exposure in female patients with different age and renal function with complaints of an uncomplicated UTI. Also the nitrofurantoin exposure in relation to the dosage regimen will be studied.

METHODS

Eight general practitioners (GP) participated in the study and included 38 patients with symptoms of an uncomplicated UTI, treated either with a dose of 50 mg q6h or 100 mg q12h, upon the discretion of the GP. Nitrofurantoin exposure was quantified in the patient's 24-h urine samples by UHPLC-UV and the area under the curve was calculated.

RESULTS

The 38 patients provided a range of 2-17 urine samples. The urine nitrofurantoin exposure was 1028 mg h/L for the patients receiving 50 mg q6h and 1036 mg h/L for those treated with 100 mg q12h (p = 0.97) and was not affected by age and eGFR (p = 0.64 and p = 0.34, respectively).

CONCLUSION

The data obtained do not support the discouragement of nitrofurantoin use in the elderly and in patients with impaired renal function. Since only a small number of patients were included, a larger study with more patients is warranted to evaluate nitrofurantoin exposure and adverse effects.

摘要

目的

本研究旨在确定有单纯性尿路感染症状的女性患者的硝呋太尔暴露情况,这些患者的年龄和肾功能不同。还将研究硝呋太尔暴露与剂量方案的关系。

方法

8 名全科医生(GP)参与了这项研究,共纳入 38 名有单纯性尿路感染症状的患者,由 GP 自行决定给予 50mg q6h 或 100mg q12h 的剂量。通过 UHPLC-UV 定量测定患者 24 小时尿液样本中的硝呋太尔暴露量,并计算曲线下面积。

结果

38 名患者提供了 2-17 个尿液样本。接受 50mg q6h 治疗的患者尿液中硝呋太尔暴露量为 1028mg·h/L,接受 100mg q12h 治疗的患者为 1036mg·h/L(p=0.97),且不受年龄和 eGFR 的影响(p=0.64 和 p=0.34)。

结论

所得数据不支持劝阻老年人和肾功能受损患者使用硝呋太尔。由于纳入的患者数量较少,需要进行更大规模的研究以评估硝呋太尔暴露和不良反应。

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