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在儿童尿路感染的抗菌治疗
Fouad Madhi1, Alexis Rybak2, Romain Basmaci3
1Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; General Pediatrics Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Infectious diseases now
|September 20, 2023
概括
儿童尿路感染 (UTI) 需要及时诊断. 本指南推使用阿米卡治疗发烧性尿路感染,包括由扩展谱β-乳糖酶产生大肠杆菌 (E-ESBL) 引起的尿路感染,以避免更严厉的治疗.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 尿路感染 (UTI) 是儿童最常见的细菌感染.
- 扩展光谱β-乳糖酶生成的大肠杆菌 (E-ESBL) 由于耐药性增加,造成了治疗挑战.
- 目前的治疗指南是基于Groupe de Pathologie Infectieuse de Pédiatrique (GPIP-SFP) 的建议.
研究的目的:
- 为儿童尿路感染提供最新的治疗建议.
- 为应对儿童中E-ESBL感染的挑战.
- 为了有利于门诊治疗,避免使用像Penems这样的广谱抗生素.
主要方法:
- 该指南基于GPIP-SFP的现有建议.
- 它强调了尿液培养和抗生素治疗之前的尿液测量棒测试的重要性,除非在特定情况下.
- 它建议阿米卡作为发烧性尿路感染的首选初始治疗方法,包括疑似或确定的E-ESBL感染.
主要成果:
- 自2012年以来,儿科中对E-ESBL耐药的大肠杆菌菌株的比例一直保持在7%至10%之间.
- 许多口服抗生素对E-ESBL无效,需要亲肠道治疗或非标准组合.
- 阿米卡辛对大多数E-ESBL菌株表现出活性.
结论:
- 艾米卡辛在儿科患者的发烧性尿路感染的初始治疗中受欢迎,包括那些患有E-ESBL感染的人.
- 这种方法的目的是避免服用抗生素,并促进门诊管理.
- 阿米卡辛可以作为急诊室或住院儿科患者的单疗法.
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