使用发烧持续时间来指导尿路感染的管理
Takeshi Yanagihara1,2, Koichi Kobayashi1, Emi Yanai2
1Department of Pediatrics, Nippon Medical School Hospital.
概括
一项使用发烧持续时间指导儿童发烧性尿路感染 (fUTI) 抗生素治疗的新方案证明有效. 这种方法消除了像计算机断层扫描这样的侵入性成像的需要.
科学领域:
- 儿童传染病 儿童传染病
- 抗微生物药物管理管理
背景情况:
- 对于儿童发烧性尿路感染 (fUTI) 的抗微生物治疗的最佳持续时间仍未确定.
- 建立基于证据的治疗指南对于有效的儿科护理至关重要.
研究的目的:
- 根据发烧分辨率评估一项用于确定儿科fUTI抗菌治疗持续时间的新方案.
- 评估先进成像在诊断fUTI并发症中的有效性和必要性.
主要方法:
- 实施了一项协议,在此协议中,抗生素的使用持续到发烧缓解后的3天,然后再进行口服治疗.
- 发烧性尿路感染的诊断需要温度≥37.5°C和尿液培养数≥5×104CFU/mL.
- 增强对比度的计算机断层扫描 (eCT) 用于诊断急性焦点细菌性炎 (AFBN) 和炎 (PN).
主要成果:
- 在分析的58名患者中,有49人患有炎炎 (PN),有9人患有急性焦点细菌性炎 (AFBN).
- 与PN相比,AFBN患者的白细胞计数和C反应性蛋白水平较高,但与PN相比,尿道发现和致病细菌类似.
- 虽然AFBN患者的发烧缓解和静脉抗生素持续时间较长,但AFBN治疗的平均时间为14.2天,比以前的报告要短,没有复发.
结论:
- 以发烧持续时间为指导的抗微生物治疗方案对儿科fUTI有效.
- 这项研究表明,像eCT这样的侵入性成像可能不必用于管理fUTI及其并发症.
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