头孢氨苄治疗慢性留置导尿管患者中耐头孢氨苄菌尿症无效。

Ineffectiveness of cephalexin in treatment of cephalexin-resistant bacteriuria in patients with chronic indwelling urethral catheters.

作者信息

Warren J W, Hoopes J M, Muncie H L, Anthony W C

出版信息

J Urol. 1983 Jan;129(1):71-3.

Abstract

Catheterized patients not only are subject to risks of bacteriuria but the catheter also may act as reservoirs for nosocomial infections. Antibiotics that are concentrated in the urine, even those to which the organisms are nominally resistant, have been advocated as a means of treatment and infection control. During a randomized study of repetitive 10-day courses of cephalexin in chronically catheterized patients we observed the impact of such treatment upon susceptible, moderately resistant and highly resistant strains of bacteria. Cephalexin diminished the persistence of cephalexin-susceptible strains. However, its effect upon moderately resistant (inhibited by 200 micrograms per ml.) was not different than its effect upon highly resistant (not inhibited by 200 micrograms per ml.) strains. Indeed, the persistence of strains of moderately and highly resistant organisms during cephalexin courses was similar to that of such organisms during comparable periods in patients not receiving cephalexin. The administration of cephalexin to chronically catheterized patients with moderately or highly resistant organisms causing bacteriuria does not clear these organisms from the urine.

摘要

导尿患者不仅面临菌尿症风险，而且导尿管还可能成为医院感染的病灶。尿液中浓度较高的抗生素，即使是那些细菌名义上耐药的抗生素，也被推荐作为一种治疗和控制感染的手段。在一项针对长期导尿患者重复使用头孢氨苄进行为期10天疗程的随机研究中，我们观察了这种治疗对敏感、中度耐药和高度耐药菌株的影响。头孢氨苄减少了对头孢氨苄敏感菌株的持续存在。然而，它对中度耐药（每毫升200微克可抑制）菌株的作用与对高度耐药（每毫升200微克不能抑制）菌株的作用并无差异。事实上，在头孢氨苄疗程中，中度和高度耐药菌的持续存在情况与未接受头孢氨苄治疗的患者在可比时期内此类细菌的情况相似。对由中度或高度耐药菌引起菌尿症的长期导尿患者使用头孢氨苄并不能清除尿液中的这些细菌。