Melekos M D, Asbach H W, Gerharz E, Zarakovitis I E, Weingaertner K, Naber K G
Department of Urology, University of Patras School of Medicine, Rio-Patras, Greece.
J Urol. 1997 Mar;157(3):935-9.
We evaluated and compared the efficacy of post-intercourse and daily oral ciprofloxacin prophylaxis against recurrent lower urinary tract infections in 135 sexually active premenopausal women.
Post-intercourse (group 1, 70 patients) and daily (group 2, 65 patients) prophylactic regimens of 125 mg. ciprofloxacin were started following a curative, conventional treatment of the initial acute urinary tract infection. Prophylaxis was maintained for 12 months and during this period patients were followed clinically and bacteriologically with urine and introital samples. Patients were subsequently followed for an additional year after the end of preventive treatment.
While 3.67 urinary tract infections per patient in group 1 and 3.74 in group 2 occurred during an identical mean time of 12.2 months before start of the corresponding prophylactic regimen, only 0.043 infection per patient in group 1 and 0.031 in group 2 developed during prophylaxis (p < 0.0001). Before prophylaxis 86% of the vaginal vestibule cultures yielded gram-negative Enterobacteriaceae, equally distributed between both treatment arms, compared to 5.6% and 2.5% during postcoital and daily prophylaxis, respectively. The overall improvement in the incidence of the urinary infections per patient and the rate of introital colonization with enteric gram-negative bacteria was maintained after the end of prophylaxis, with a mean incidence of infections of 0.44 per patient (occurring in 34% of the total patient population), while 36% of all women had abnormal introital colonization.
Long-term post-intercourse prophylaxis with ciprofloxacin proved to be equally effective as daily prophylaxis, and the major advantage of the former therapy was use of only a third of the amount of drug consumed in daily prophylaxis.
我们评估并比较了性交后及每日口服环丙沙星预防135名性活跃的绝经前女性复发性下尿路感染的疗效。
在对初始急性尿路感染进行治愈性常规治疗后，开始采用性交后（第1组，70例患者）和每日（第2组，65例患者）125毫克环丙沙星的预防方案。预防持续12个月，在此期间，对患者进行临床随访，并采集尿液和阴道入口样本进行细菌学检测。预防性治疗结束后，对患者再随访一年。
在相应预防方案开始前的相同平均12.2个月时间内，第1组患者每人发生3.67次尿路感染，第2组为3.74次，而在预防期间，第1组患者每人仅发生0.043次感染，第2组为0.031次（p<0.0001）。预防前，86%的阴道前庭培养物检出革兰氏阴性肠杆菌科细菌，两组治疗组分布均匀，而在性交后预防和每日预防期间，这一比例分别为5.6%和2.5%。预防结束后，每位患者尿路感染发生率和肠道革兰氏阴性菌阴道入口定植率的总体改善情况得以维持，每位患者感染的平均发生率为0.44次（占患者总数的34%），而所有女性中有36%的阴道入口定植异常。
长期性交后用环丙沙星预防与每日预防同样有效，前一种疗法的主要优点是所用药物量仅为每日预防的三分之一。
