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女性における急性非合併症性膀炎を引き起こす尿病原体の中で抗菌剤耐性の流行率が増加しています
K Gupta1, D Scholes, W E Stamm
1Department of Medicine, University of Washington School of Medicine, Seattle 98195, USA.
JAMA
|March 3, 1999
まとめ
トリメトプリム-スルファメトキサゾールなどの一般的な膀炎治療に対する抗菌剤耐性は,女性において有意に増加した. しかし,ニトロフラントインとシプロフロクサシンに対する耐性は低いままであり,代替の経験的治療の選択肢を提供した.
科学分野:
- 泌尿器科 泌尿器科とは
- 感染症 感染症は感染症です.
- 薬理学 薬理学とは
背景:
- 急性非合併症性膀炎の経験的治療は,予測可能な尿病原体耐性パターンに依存しています.
- 抗菌剤の感受性を理解することは,効果的な治療ガイドラインを決定的に重要です.
研究 の 目的:
- 女性における急性非合併症性膀炎を引き起こす尿病原体における抗菌剤耐性の流行と傾向を決定する.
- 現在の耐性データに基づいた実証的治療戦略を伝えるために.
主な方法:
- 急性膀炎を患っている18~50歳の女性の尿分子の5年間の横断調査 (1992~1996).
- 一般的な尿病原体,主にエシェリキア・コライおよびスタフィロコッカス・サプロフィティカスに対する抗微生物感受性のパターンの分析.
主要な成果:
- エシェリキア・コライとスタフィロコッカス・サプロフィティカスは,単離物の90%を占めた.
- アンピシリン,セファロチン,スルファメトキサゾールに対する耐性が年間20%以上も認められた.
- トリメトプリム-スルファメトキサゾールに対するE. coliの耐性は,9% (1992年) から18% (1996年) 以上に増加した.
- ニトロフラントイン,ジェンタミシン,シプロフロクサシンには低耐性 (<10%) と安定した感受性パターンが示された.
結論:
- トリメトプリム・スルファメトキサゾール,アンピシリン,セファロチンに対する耐性の有意な増加が認められた.
- ニトロフラントインとシプロフロクサシンは持続的な低耐性を示し,有効な選択肢として残っています.
- 効能と費用に加えて,感受性のデータは,急性非合併症性囊炎の経験的治療法の選択を導くべきである.
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