Botto H
Service d'Urologie, Centre Médico-Chirurgical Foch, Suresnes.
Presse Med. 1995 Oct 28;24(32):1491-3.
There is little reason why the organism could benefit from the presence of micro-organisms in the urine. In the case of severe infection, the consequences can be devastating, both for the health of the individual and for the overall effect in terms of health care costs. There is thus a clear need for a reduction in the number and severity of urinary tract infections by a strictly controlled, well-planned, antibiotic prophylaxy. Beyond well-established rules concerning timing, duration, dose and, in certain cases, indications of antibiotics, there remains a number of questions yet to be fully understood. What is the ecologic impact of antibiotic prophylaxy? What is the original source of infection in patients undergoing multiple procedures? What is the relationship between serum concentrations and efficacy? What is the role of in situ germs and nosocomial agents? These and other questions require rigorously conducted research where not only urologists but also bacteriologists, infectiologists and public health specialists all have an important role to play.
生物体几乎没有理由从尿液中存在的微生物中获益。在严重感染的情况下,后果可能是毁灭性的,无论是对个体健康还是对医疗保健成本的总体影响而言。因此,显然需要通过严格控制、精心规划的抗生素预防措施来减少尿路感染的数量和严重程度。除了关于抗生素使用时间、持续时间、剂量以及在某些情况下适应证的既定规则外,仍有许多问题有待充分理解。抗生素预防的生态影响是什么?接受多次手术的患者感染的原始来源是什么?血清浓度与疗效之间的关系是什么?原位细菌和医院感染病原体的作用是什么?这些以及其他问题需要进行严谨的研究,在这方面,不仅泌尿科医生,而且细菌学家、感染病学家和公共卫生专家都要发挥重要作用。