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Clin Microbiol Infect:尿液提取物和布洛芬作为治疗女性非复杂性尿路感染的替代疗法

2020-05-31 MedSci原创 MedSci原创

本研究旨在探究在延迟处方的同时提供对症治疗(乌韦-尿西或布洛芬)是否能缓解症状,并减少急性非并发性尿路感染(UTI)成年妇女的抗生素用量。

本研究旨在探究在延迟处方的同时提供对症治疗(乌韦-尿西或布洛芬)是否能缓解症状,并减少急性非并发性尿路感染(UTI)成年妇女的抗生素用量。

 

一项2×2因子对照随机试验,在基层医疗机构进行。参与者为382名年龄在18-70岁,有排尿困难、尿急、尿频或尿频症状,并经临床医生怀疑为下尿路感染(UTI)的女性。干预措施为尿毒症提取物和/或布洛芬建议。所有妇女均获得延迟或 "后备 "抗生素处方。遗漏数据采用多重归纳法(ISRCTN登记表:ISRCTN43397016)进行了估算。

 

对第2-4天评估的频率症状平均得分的ITT分析发现,没有证据表明乌韦-尿西与安慰剂之间的差异-0.06(95% CI-0.33至0.21;P 0.661),也没有证据表明布洛芬与无布洛芬建议的差异-0.01(95% CI-0.27至0.26;P 0.951)。没有证据表明,使用乌发-尿嘧啶的抗生素用量减少(39.9% vs. 安慰剂 47.4%;logistic回归胜率比(OR)0.59(95% CI 0.22~1.58;p 0.293),但布洛芬建议显著减少(34.9% vs. 无建议 51.0%;OR 0.27(95% CI 0.10~0.72;p 0.009)。没有安全问题,也没有记录到上呼吸道感染的发作。

 

总之,该研究结果表明,没有发现任何干预措施对频率症状的严重程度有影响的证据。有证据表明,建议服用布洛芬会减少抗生素的用量,而不会增加并发症。每7名妇女接受这一建议,就会少用1名抗生素。

 

原始出处:

 

M Moore, J Trill, et al., Uva-ursi Extract and Ibuprofen as Alternative Treatments for Uncomplicated Urinary Tract Infection in Women (ATAFUTI): A Factorial Randomized Trial. Clin Microbiol Infect. 2019 Aug;25(8):973-980. doi: 10.1016/j.cmi.2019.01.011.  

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    2021-07-25 是鱼鱼呀

    布洛芬替代抗生素?

    0

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    2021-03-01 sunylz
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    2020-12-24 xjy02
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1002628, encodeId=aad710026282e, content=布洛芬替代抗生素?, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c9df5468537, createdName=是鱼鱼呀, createdTime=Sun Jul 25 23:51:16 CST 2021, time=2021-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1767767, encodeId=72201e67767e0, content=<a href='/topic/show?id=64f5343e2f' target=_blank style='color:#2F92EE;'>#Biol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3437, encryptionId=64f5343e2f, topicName=Biol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446937890434, createdName=12498ebem31暂无昵称, createdTime=Sun Jan 03 04:03:13 CST 2021, time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1919080, encodeId=d5e519190800c, content=<a href='/topic/show?id=4f26341994' target=_blank style='color:#2F92EE;'>#Bio#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3419, encryptionId=4f26341994, topicName=Bio)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Mon Mar 01 13:03:13 CST 2021, time=2021-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648377, encodeId=d55716483e7b7, content=<a href='/topic/show?id=1b88603298d' target=_blank style='color:#2F92EE;'>#替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60329, encryptionId=1b88603298d, topicName=替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f1023558367, createdName=skhzy, createdTime=Wed Jan 20 13:03:13 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084588, encodeId=d6d9208458823, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Thu Dec 24 22:03:13 CST 2020, time=2020-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857885, encodeId=f415185e88570, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Jul 03 21:03:13 CST 2020, time=2020-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449393, encodeId=996014493937d, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Tue Jun 02 08:03:13 CST 2020, time=2020-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587250, encodeId=4283158e250ef, content=<a href='/topic/show?id=9b4a42e01ed' target=_blank style='color:#2F92EE;'>#复杂性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42701, encryptionId=9b4a42e01ed, topicName=复杂性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b19f17453483, createdName=minlingfeng, createdTime=Tue Jun 02 08:03:13 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1002628, encodeId=aad710026282e, content=布洛芬替代抗生素?, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c9df5468537, createdName=是鱼鱼呀, createdTime=Sun Jul 25 23:51:16 CST 2021, time=2021-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1767767, encodeId=72201e67767e0, content=<a href='/topic/show?id=64f5343e2f' target=_blank style='color:#2F92EE;'>#Biol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3437, encryptionId=64f5343e2f, topicName=Biol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446937890434, createdName=12498ebem31暂无昵称, createdTime=Sun Jan 03 04:03:13 CST 2021, time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1919080, encodeId=d5e519190800c, content=<a href='/topic/show?id=4f26341994' target=_blank style='color:#2F92EE;'>#Bio#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3419, encryptionId=4f26341994, topicName=Bio)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Mon Mar 01 13:03:13 CST 2021, time=2021-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648377, encodeId=d55716483e7b7, content=<a href='/topic/show?id=1b88603298d' target=_blank style='color:#2F92EE;'>#替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60329, encryptionId=1b88603298d, topicName=替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f1023558367, createdName=skhzy, createdTime=Wed Jan 20 13:03:13 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084588, encodeId=d6d9208458823, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Thu Dec 24 22:03:13 CST 2020, time=2020-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857885, encodeId=f415185e88570, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Jul 03 21:03:13 CST 2020, time=2020-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449393, encodeId=996014493937d, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Tue Jun 02 08:03:13 CST 2020, time=2020-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587250, encodeId=4283158e250ef, content=<a href='/topic/show?id=9b4a42e01ed' target=_blank style='color:#2F92EE;'>#复杂性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42701, encryptionId=9b4a42e01ed, topicName=复杂性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b19f17453483, createdName=minlingfeng, createdTime=Tue Jun 02 08:03:13 CST 2020, time=2020-06-02, status=1, ipAttribution=)]

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复发性尿路感染(rUTIs)是极度常见的,且大约25%的女性在她们的起始感染后1年内经历复发。大肠杆菌ST131是一种具有全球多种耐药性的抗性克隆,并且与rUTI的高发病率相关。最近,有研究人员在一名患有rUTI的女性中展示了ST131群体动态情况,时间从1970s开始,动态展示时间为5年。研究人员通过使用全基因组测序方法,鉴定了一个与rUTI和粪便菌群持久性有关的土著无性菌系(P1A),为rUT

美国FDA批准了日本盐野义制药的Fetroja,用于复杂尿路感染患者

美国食品和药物管理局(FDA)批准了盐野义制药Shionogi的Fetroja(cefiderocol)用于特定类型复杂尿路感染(cUTI)的患者。根据药物的有限临床安全性和有效性数据,该组织批准了Fetroja用于18岁及以上,治疗选择有限或没有其他选择的患者。

J Urol:为什么预防复发性尿路感染不会导致更少的肾脏瘢痕?

RIVUR(膀胱输尿管反流患儿随机干预)试验报告称,抗生素预防减少了复发性尿路感染,但抗生素预防与新的肾脏瘢痕减少无关。然而,最初的报道并没有详细评估复发性尿路感染、新的肾脏瘢痕和抗生素预防之间的关系

Diabetes Obes Metab:SGLT2抑制剂与生殖器真菌感染和尿路感染的风险

由此可见,在老年女性和男性中使用SGLT2抑制剂与30天内生殖器真菌感染的风险增加有关,而与UTI风险增加无关。来自现实环境的这些发现提供了SGLT2抑制剂存在潜在危害的证据。

2 型糖尿病伴发复发性尿路感染一例

患者49岁,男,因“口渴、多饮、多尿14a,尿频、尿急、尿痛2个月”于2014年7月17日入院。14a前出现口渴、多饮、多尿,当地医院测随机血糖20mmol/L,诊为“2型糖尿病”,不规则口服“消渴丸、二甲双胍”治疗,偶测空腹血糖,波动于13~14mmol/L。1a前出现双足背麻木,呈对称性,无双足疼痛、蚁走感,无腹泻与便秘交替,未治疗。

Pediatr Infect Dis J:头孢西丁胺-阿维菌素治疗≥3个月至18岁儿童并发尿路感染的安全性和有效性

头孢噻啶胺-阿维菌素对成人复杂尿路感染(cUTI)有效且耐受性良好,但尚未对儿童cUTI患者进行评估。

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