儿童的复发性尿路感染:风险因素和与预防性抗微生物药物的相关性
Patrick H Conway1, Avital Cnaan, Theoklis Zaoutis
1Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA 19104, USA. pconway2@mail.med.upenn.edu
JAMA
|July 12, 2007
概括
抗微生物预防没有减少儿童的复发性尿路感染 (UTI). 然而,它增加了反复性尿路感染中抗生素耐药性的风险,突出了对儿科护理的关键问题.
科学领域:
- 儿童传染病 儿童传染病
- 临床流行病学临床流行病学
- 抗微生物药物管理管理
背景情况:
- 关于尿路感染 (UTI) 风险因素和儿童抗微生物预防的有效性,证据有限.
- 复发性尿路感染在儿科初级保健中构成了重大挑战.
研究的目的:
- 确定6岁或更年轻儿童复发性尿路感染的危险因素.
- 确定抗微生物预防和复发性尿路感染之间的关联.
- 确定反复性尿路感染中抗菌素耐药性的风险因素.
主要方法:
- 来自27家儿科诊所的611名首次尿路感染儿童的队列研究.
- 时间到事件分析,以评估风险因素和预防的关联.
- 嵌套病例控制研究以确定耐药性风险因素.
主要成果:
- 白人种族,年龄为3-5岁,以及4-5级膀肠回流与增加的复发性尿路感染风险有关.
- 抗微生物预防没有显示出与减少复发性尿路感染风险的显著关联.
- 抗微生物预防是复发性尿路感染中抗微生物耐药性的重要危险因素.
结论:
- 抗微生物预防与儿童复发性尿路感染的风险降低无关.
- 预防性使用与儿童尿路感染中发展抗性感染的风险增加有关.
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