Hirose T, Kumamoto Y, Sakai S, Shimamura S, Shibuya A, Yamazaki K, Umehara T, Miyake M, Takatsuka K, Aoki M
Department of Urology, School of Medicine, Sapporo Medical University.
Kansenshogaku Zasshi. 1995 Jan;69(1):33-44. doi: 10.11150/kansenshogakuzasshi1970.69.33.
Female acute uncomplicated cystitis responds relatively well to antimicrobial chemotherapy. In particular, new quinolones are suited for use as antimicrobial agents in single-dose therapy of female acute uncomplicated cystitis since they have a long serum half-life and express potent antimicrobial activity against the causative microbes of this infection. Lomefloxacin (LFLX) is one such new quinolone which shows a long serum half-life, expresses potent antimicrobial activity against Escherichia coli (E. coli) and maintains an effective urinary drug concentration for approximately three days after a single administration. The authors carried out a comparative investigation of the clinical efficacy of single doses of 100 mg and 300 mg of LFLX in the treatment of female acute uncomplicated cystitis. The clinical efficacy rates with these doses, evaluated on the 3rd day after administration, were 98.2% (56/57 cases) for the 100mg-LFLX dose and 100% (62/62 cases) for the 300-mg LFLX dose. When the evaluation was performed on the 7th day after administration, the clinical efficacy rates were 91.3% (42/46 cases) for the 100-mg LFLX dose and 95.8% (46/48 cases) for the 300-mg LFLX dose. In addition, the microbial eradication rates were 73.7% (42/57 cases) for the 100-mg LFLX group and 75.8% (47/62 cases) for the 300-mg LFLX group on the 3rd day after administration, and 71.7% (33/46 cases) for the 100-mg LFLX group and 83.3% (40/48 cases) for the 300-mg LFLX group on the 7th day after administration. Although there were no statistically significant differences between the two LFLX dosage groups for these parameters at either of the evaluation times, the rates for the 300-mg LFLX dose were slightly superior. The investigators judged the efficacy of the LFLX treatment as having been insufficient in 12 patients, and urological examinations performed on six of those cases determined that there were mild underlying diseases in four cases, such as stenosis of the urethral meatus. On the basis of the findings described above, it is clear that a single 100-mg dose of LFLX provided sufficient clinical efficacy in the treatment of female acute uncomplicated cystitis, but the efficacy of the 300-mg dose of LFLX was even better. In addition, it was surmised that performance of detailed urological examinations provides an opportunity to detect mild underlying diseases that may be the cause of the intractability in female acute uncomplicated cystitis cases showing an insufficient response to treatment with antimicrobial agents such as LFLX.
女性急性单纯性膀胱炎对抗菌化疗反应相对较好。特别是,新型喹诺酮类药物适用于女性急性单纯性膀胱炎的单剂量治疗,因为它们具有较长的血清半衰期,并且对这种感染的致病微生物具有强大的抗菌活性。洛美沙星(LFLX)就是这样一种新型喹诺酮类药物,它具有较长的血清半衰期,对大肠杆菌(E. coli)具有强大的抗菌活性,单次给药后可维持约三天的有效尿药浓度。作者对单剂量100mg和300mg的LFLX治疗女性急性单纯性膀胱炎的临床疗效进行了比较研究。给药后第3天评估,100mg - LFLX剂量组的临床有效率为98.2%(56/57例),300mg LFLX剂量组为100%(62/62例)。给药后第7天进行评估时,100mg LFLX剂量组的临床有效率为91.3%(42/46例),300mg LFLX剂量组为95.8%(46/48例)。此外,给药后第3天,100mg LFLX组的微生物清除率为73.7%(42/57例),300mg LFLX组为75.8%(47/62例);给药后第7天,100mg LFLX组为71.7%(33/46例),300mg LFLX组为83.3%(40/48例)。尽管在两个评估时间点,两个LFLX剂量组在这些参数上均无统计学显著差异,但300mg LFLX剂量组的比率略高。研究人员判定12例患者的LFLX治疗效果不佳,对其中6例进行的泌尿外科检查确定,4例存在轻度基础疾病,如尿道口狭窄。基于上述发现,显然单剂量100mg的LFLX在治疗女性急性单纯性膀胱炎时提供了足够的临床疗效,但300mg剂量的LFLX疗效更好。此外,据推测,进行详细的泌尿外科检查可以提供一个机会,以检测出可能是女性急性单纯性膀胱炎对抗菌药物(如LFLX)治疗反应不佳的原因的轻度基础疾病。