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[复发性膀胱炎的抗生素预防。两种剂量培氟沙星的随机双盲对照试验]

[Antibioprevention of recurrent cystitis. A randomized double-blind comparative trial of 2 dosages of pefloxacin].

作者信息

Guibert J, Humbert G, Meyrier A, Jardin A, Vallancien G, Piccoli S, Delavault P

机构信息

Service de Microbiologie médicale, Fondation Hôpital Saint-Joseph, Paris.

出版信息

Presse Med. 1995 Jan 28;24(4):213-6.

PMID:7899366
Abstract

OBJECTIVES

The aim of this randomized double-blind trial was to compare two 400 mg pefloxacin regimens either once-a-week or once-a-month applied for 48 weeks for the prophylaxis of recurrent urinary tract infection in women.

METHODS

The main outcome measures were symptomatic and bacteriological reinfections during the period of prophylaxis and rates of reinfections during the three months of surveillance following the end of prophylaxis. 361 women of 18 to 51 years of age suffering from recurrent lower urinary tract infection were randomly allocated to receive pefloxacin 400 mg once-a-week (group A: n = 185) or 400 mg once-a-month (groupe B: n = 176) for 48 weeks.

RESULTS

Seventeen of the 185 patients in group A (9.1%) and 52/176 patients in group B (29.5%) experienced at least one reinfection during the period of prophylaxis (p < 0.0001). The rates of reinfection during the three months of surveillance following the end of the treatment were not significantly different between the two groups with 14/101 (13.8%) patients with at least a reinfection in group A and 8/75 patients (10.6%) in group B (p = 0.51). In group A, 49/174 (28.1%) patients reported at least an adverse event compared with 33/169 (19.5%) patients in group B (p = 0.06).

CONCLUSIONS

Once-a-week treatment with 400 mg of pefloxacin can be considered as a new effective and well tolerated approach for the prophylaxis of recurrent urinary tract infection in women and does not entail excessive emergence of pefloxacin resistant bacteria, even after 48 weeks of treatment.

摘要

目的

本随机双盲试验旨在比较两种400mg培氟沙星方案,即每周一次或每月一次,应用48周预防女性复发性尿路感染的效果。

方法

主要观察指标为预防期间的症状性和细菌性再感染以及预防结束后三个月监测期内的再感染率。361例年龄在18至51岁的复发性下尿路感染女性被随机分配接受400mg培氟沙星每周一次(A组:n = 185)或每月一次(B组:n = 176),共48周。

结果

A组185例患者中有17例(9.1%),B组176例患者中有52例(29.5%)在预防期间经历了至少一次再感染(p < 0.0001)。治疗结束后三个月监测期内,两组再感染率无显著差异,A组101例患者中有14例(13.8%)至少发生一次再感染,B组75例患者中有8例(10.6%)(p = 0.51)。A组174例患者中有49例(28.1%)报告至少发生一次不良事件,B组169例患者中有33例(19.5%)(p = 0.06)。

结论

400mg培氟沙星每周一次治疗可被视为预防女性复发性尿路感染的一种新的有效且耐受性良好的方法,即使在治疗48周后,也不会导致培氟沙星耐药菌过度出现。

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