增加水分,D-曼诺斯和抗生素预防在绝经前妇女的复发性尿路感染的比较:三臂随机对照研究
Vincenzo Iossa1, Stefano Masciovecchio2, Giovanni Battista Clemente2
1Department of Urology, Azienda Ospedaliera "S.G. Moscati", Avellino, Italy. vincenzoiossa@msn.com.
International urology and nephrology
|August 25, 2025
概括
抗生素预防最有效地预防女性的尿路感染,但D-曼诺斯提供了安全的非抗生素替代品. 增加水分是不太有效的,但安全的基线措施.
科学领域:
- 泌尿外科
- 传染性疾病
- 药理学
背景情况:
- 回复性尿道感染 (rUTIs) 严重影响绝经前妇女的生活质量,并导致高医疗费用.
- 抗生素耐药性需要探索非抗生素预防RUTI的策略.
- 对于目前的RUTI预防措施存在有限的比较数据.
研究的目的:
- 为了比较增加水分,D-曼诺斯和抗生素预防在绝经前妇女的有效性和安全性.
- 在抗菌素耐药性上升的背景下评估非抗菌素替代品.
主要方法:
- 这是一项为期12个月的前性随机控制多中心研究.
- 75名患有每年≥3次尿路感染的绝经前妇女被随机分配给增加水分,D- 曼诺斯或低剂量抗生素预防.
- 主要终点:尿路感染次数/年 二次终点:第一个尿路感染的时间,不良事件.
主要成果:
- 抗生素预防显示最低的RUTI发病率 (0. 2次/年),明显优于增加水分 (1. 08次/年).
- D- 曼诺斯的疗效是中等的 (0. 32次/ 年),与水分相比有显著的趋势.
- 抗生素 (4. 5个月) 与D- 曼诺斯 (2. 5个月) 和补水 (1个月) 的平均时间最长. 使用抗生素的轻微不良反应更为常见.
结论:
- 低剂量抗生素预防仍然是绝经前妇女最有效的RUTI预防策略.
- D-曼诺是一种有前途的,安全的非抗生素替代品,具有显著的疗效.
- 增加水分是安全的,经济的基线措施;建议采取个性化的方法来对抗抗菌素耐药性.
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