Cefpodoxime vs ciprofloxacin 急性非合併症性膀炎の短期治療:ランダム化試験について
Thomas M Hooton1, Pacita L Roberts, Ann E Stapleton
1Department of Medicine, School of Medicine, University of Miami, Miami, Florida 33136, USA. thooton@med.miami.edu
JAMA
|February 10, 2012
まとめ
Cefpodoximeは,急性非合併症性膀炎の治療においてシプロフロクサシンに劣らないとは認められませんでした. この研究は,セフポドキシメがフルオロキノロンに適したファーストラインの代替品ではないことを示唆しています.
科学分野:
- 感染症 感染症は感染症です.
- 薬理学 薬理学とは
- 泌尿器科 泌尿器科とは
背景:
- フルオロキノロンは尿路感染症の標準薬ですが,耐性が高まると代替薬が必要になります.
- 効果的なフルオロキノロン貯蔵剤は,合併症のない膀炎の管理に不可欠です.
研究 の 目的:
- セフポドキシメが,急性囊炎の治療においてシプロフロクサシンに劣らない代替品であるかどうかを評価する.
- 臨床的および微生物学的治癒率を比較し,陰道におけるE. coliコロニー化を評価する.
主な方法:
- ランダム化され,二重盲検試験で,急性不合併性膀炎を患った300人の女性を対象とした.
- シプロフロキサシンとセフポドキシームプロキセチルの3日間の投与レジメンの比較.
- 治療後5~9日および28~30日後に評価されたアウトカムには,臨床的治癒とE. coliのコロニー化が含まれています.
主要な成果:
- シプロフロキサシンは,セフポドキシームと比較して,より高い臨床治癒率 (93%対82%の治療意図) と微生物学的治癒率 (96%対81%) を示しました.
- Cefpodoximeは,シプロフロクサシンに対する非劣等性基準を満たさなかった.
- 内E. coliのコロニゼーションは,セフポドキシーム群 (40%対16%) で有意に高かった.
結論:
- Cefpodoximeは,急性非合併症性膀炎において,シプロフロクサシンに劣らないことを示さなかった.
- 幅広いスペクトルの薬剤の生態学的影響に関する懸念は,セフポドキシームをフルオロキノロンを節約する第一線の選択肢として支持しない.
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