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美国单纯性尿路感染女性对抗生素的过敏反应。

Allergies to antibiotics among US women with uncomplicated urinary tract infection.

机构信息

GSK, Collegeville, Pennsylvania, United States of America.

GSK, Wavre, Belgium.

出版信息

PLoS One. 2024 Sep 26;19(9):e0304318. doi: 10.1371/journal.pone.0304318. eCollection 2024.

Abstract

Uncomplicated urinary tract infections (uUTI) are generally treated empirically with antibiotics. However, antibiotic allergies limit the available oral treatment options for some patients. We assessed the proportion of self-reported antibiotic allergies among US women with uUTI. We performed a cross-sectional survey of US women (≥18 years) with a self-reported uUTI in the previous 60 days and an oral antibiotic prescription. Participants completed an online questionnaire about their most recent uUTI episode. Descriptive self-reported allergy data were stratified into subgroups by whether the participant had recurrent UTI (≥2 uUTIs in the past 6 months or ≥3 uUTIs in past 12 months, including the index episode), the number of different antibiotics given for the index episode (1, 2, ≥3), and whether the treatment was clinically aligned according to Infectious Diseases Society of America uUTI guidelines. Overall, 375 participants completed the questionnaire. The most commonly prescribed antibiotics were trimethoprim-sulfamethoxazole (SXT; 38.7%), ciprofloxacin (22.7%), and nitrofurantoin (18.9%). Most participants (62.7%) received only 1 antibiotic for their uUTI, and most (56.5%) were classified as having a non-recurrent uUTI. No antibiotic allergies were reported for most participants (69.3%), with 24.0% reporting 1 antibiotic allergy and 6.7% reporting ≥2 antibiotic allergies. Allergies to ≥2 antibiotic types were more common among participants classified as having recurrent uUTI, or who used multiple antibiotics to treat their uUTI. The most common allergy was to SXT (15.7%), followed by amoxicillin-clavulanate (8.3%) and ciprofloxacin (5.3%). Similar allergy trends were seen across subgroups, except higher rates of ciprofloxacin allergy were seen in participants given multiple antibiotics. Antibiotic allergies were relatively frequent in this uUTI cohort and the most common allergy was to SXT, which was the most prescribed antibiotic. Allergies to antibiotics reduce the available treatment options for uUTI in some patients.

摘要

非复杂性尿路感染(uUTI)通常采用经验性抗生素治疗。然而,抗生素过敏会限制某些患者的口服治疗选择。我们评估了美国患有 uUTI 的女性中自我报告的抗生素过敏比例。我们对过去 60 天内患有自我报告的 uUTI 并开具了口服抗生素处方的美国女性进行了横断面调查。参与者完成了一份关于其最近 uUTI 发作的在线问卷。根据参与者是否患有复发性 UTI(过去 6 个月内发生 2 次或过去 12 个月内发生 3 次 uUTI,包括本次发作)、本次发作使用的不同抗生素数量(1、2、≥3)以及治疗是否与美国传染病学会 uUTI 指南一致,对描述性自我报告的过敏数据进行分层。总体而言,375 名参与者完成了问卷。最常开的抗生素是复方磺胺甲噁唑(SXT;38.7%)、环丙沙星(22.7%)和呋喃妥因(18.9%)。大多数参与者(62.7%)仅接受 1 种抗生素治疗 uUTI,大多数(56.5%)被归类为非复发性 uUTI。大多数参与者(69.3%)未报告抗生素过敏,24.0%报告 1 种抗生素过敏,6.7%报告≥2 种抗生素过敏。在被归类为患有复发性 uUTI 的参与者或使用多种抗生素治疗 uUTI 的参与者中,对≥2 种抗生素类型过敏更为常见。最常见的过敏是对 SXT(15.7%),其次是阿莫西林克拉维酸(8.3%)和环丙沙星(5.3%)。在各个亚组中均观察到类似的过敏趋势,但在使用多种抗生素的参与者中,环丙沙星过敏的发生率更高。在该 uUTI 队列中,抗生素过敏相对常见,最常见的过敏是对 SXT,这也是最常开的抗生素。抗生素过敏会降低某些患者 uUTI 的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1854/11426493/dd92e4ba202e/pone.0304318.g001.jpg

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