在ESBL产生的大肠杆菌下尿道感染中Cefixime-clavulanic acid:一个13名患者的病例系列
Sinan Mermer1,2, Deniz Akyol3,4, Mehmet Buğra Özkara3
1Department of Infectious Diseases and Clinical Microbiology, Izmir University of Economics, Faculty of Medicine, Medical Point Hospital, Izmir, Türkiye. sinan.mermer@ieu.edu.tr.
BMC infectious diseases
|September 30, 2025
概括
口服塞菲西姆 - 克拉夫兰酸在治疗由扩展谱β-乳糖酶生成的大肠杆菌引起的尿路感染 (UTI) 方面表现有前途. 这种口服选择为静脉注射治疗提供了替代方案,并可能有助于对抗抗生素耐药性.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 微生物学 微生物学
背景情况:
- 尿路感染 (UTI) 是一种常见的社区感染.
- 产生扩展谱β-乳糖酶 (ESBL) 的大肠杆菌 (E. coli) 菌株使尿路感染治疗复杂化.
- 口服抗生素替代品是必要的,因为目前的静脉注射选择的局限性,如carbapenems.
研究的目的:
- 评估口服塞菲西姆-克拉夫兰酸对较低尿路感染的临床和微生物学结果.
- 评估塞菲克西姆-克拉夫兰酸对产生ESBL的大肠杆菌的疗效.
- 探索对较旧的抗生素和卡巴胺耐药性发展的潜在替代品.
主要方法:
- 对13名患有ESBL产生的大肠杆菌引起的下部尿路感染的患者进行了回顾性研究.
- 用口服塞菲西姆-克拉夫兰酸治疗 (400/125毫克每12小时14天).
- 在3-5日和/或治疗结束 (11-14日) 的后续尿液培养.
主要成果:
- 在治疗结束时,微生物学成功率达到80%,临床成功率达到84.6%.
- 早期治疗 (3-5天) 的微生物学和临床成功率分别为53.8%和61.5%.
- 在治疗后,再感染发生在7.7%的患者中,复发发生在30.8%的患者中.
结论:
- 口服塞菲西姆 - 克拉夫兰酸可能是无并发性尿路感染的替代方案,可能有助于预防卡巴胺耐药性.
- 研究结果表明,塞菲克西姆 - 克拉夫兰酸可以作为斯福米辛和尼托福兰因的替代品.
- 结果需要谨慎解释,因为样本大小小,回顾性设计和缺乏对照组;需要进行更大的研究.
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