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成人女性单纯性尿路感染抗生素的使用:SCOUT试验的定性研究结果

The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial.

作者信息

Munné-Barellas Berta, Monfà Ramon, Llor Carl, Garcia-Sangenís Ana, Miranda-Jiménez Cristina, Morros Rosa, Moragas Ana, Alvarez-Greciano Pablo, Leiva Alfonso, Lozano-Del Hoyo Mª Luisa, Sánchez-Calavera Maria Antonia, Marín-Cañada Jaime, Sánchez-Ruano Raquel

机构信息

Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.

Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.

出版信息

Patient Prefer Adherence. 2025 Aug 31;19:2673-2685. doi: 10.2147/PPA.S531582. eCollection 2025.

Abstract

BACKGROUND

This paper focuses on women's subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences.

OBJECTIVE

The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial.

METHODS

This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis.

RESULTS

UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case.

CONCLUSION

This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.

摘要

背景

本文聚焦于女性患尿路感染及使用抗生素的主观体验。单纯性尿路感染是初级医疗中最常治疗的感染之一,然而,关于患者体验及其对抗生素治疗的偏好,证据有限。

目的

本研究旨在收集有关抗生素使用及参与临床试验的体验、信念和态度。

方法

本定性子研究是SCOUT项目的一部分,该项目通过一项临床试验,旨在评估四种短疗程抗生素治疗方案(单剂量3克磷霉素;3克磷霉素服用两天;400毫克匹美西林服用三天;100毫克呋喃妥因服用五天)的有效性。在西班牙的四个地区(加泰罗尼亚N = 19、阿拉贡N = 19、马德里N = 15和巴利阿里群岛N = 15)共进行了68次半结构化访谈。采用了立意抽样和理论抽样方法。参与者在参加临床试验后被招募。数据收集于2024年3月至7月进行,并使用主题分析法进行分析。

结果

尿路感染并未引起过多担忧,除非抗生素治疗无效或参与者过去曾经历多次感染。磷霉素是最广为人知的抗生素,两剂量方案通常因其服用方便且比单剂量治疗更有效而受到好评。较长疗程可能会引起一些副作用,但在某些情况下,人们认为其更有效。对参与临床试验持积极态度,因为它有助于增加对尿路感染及其治疗所用抗生素的总体认识,并确保对每个具体病例进行更密切的监测。

结论

本研究收集了与尿路感染、抗生素治疗方案以及参与SCOUT临床试验相关的体验。它强调了记录尿路感染实际情况以改进未来临床试验的必要性。

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