儿童尿路感染

IF 4.2 Q3 Pharmacology, Toxicology and Pharmaceutics Recent patents on inflammation & allergy drug discovery Pub Date : 2019-01-01 DOI:10.2174/1872213X13666181228154940
Alexander K C Leung, Alex H C Wong, Amy A M Leung, Kam L Hon
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引用次数: 0

摘要

背景:尿路感染(UTI)是一种常见的儿童感染。及时诊断和适当治疗对降低该病的发病率非常重要:提供有关儿童尿路感染的评估、诊断和治疗的最新信息:方法:使用关键词 "尿路感染"、"肾盂肾炎 "或 "膀胱炎 "在PubMed上进行临床检索。搜索策略包括荟萃分析、随机对照试验、临床试验、观察性研究和综述。检索仅限于英文文献和儿科年龄组。在 www.google.com/patents、http://espacenet.com 和 www.freepatentsonline.com.Results 中使用关键词 "尿路感染"、"肾盂肾炎 "或 "膀胱炎 "检索专利:大肠杆菌占儿童尿路感染的 80% 至 90%。整个婴儿期的症状和体征都是非特异性的。不明原因的发烧是出生后头两年尿毒症最常见的症状。出生后第二年,肾盂肾炎的症状和体征包括发热、寒战、僵硬、侧腹疼痛和肋脊角压痛。下尿路症状和体征包括耻骨上疼痛、排尿困难、尿频、尿急、尿液混浊、尿液恶臭和耻骨上压痛。怀疑患上尿道炎时,应进行尿液分析和尿液培养。在对患有尿道炎的儿童进行检查时,医生必须明智地使用影像学检查,以尽量减少儿童受到的辐射。在等待培养结果期间,应根据临床发现和阳性尿液分析结果对有症状的 UTI 患者及时使用抗生素治疗,以根除感染并改善临床疗效。选择抗生素时应考虑当地的抗生素耐药性模式数据。本文讨论了与UTI治疗相关的最新专利:目前,第二代或第三代头孢菌素和阿莫西林-克拉维酸是治疗急性无并发症UTI的首选药物。对于≤2 个月的婴儿和任何面色发黄、血流动力学不稳定、免疫力低下、不能耐受口服药物或对口服药物无反应的患儿,建议使用肠外抗生素治疗。在这些情况下,可联合使用静脉注射氨苄西林和静脉注射/肌肉注射庆大霉素或第三代头孢菌素。常规的抗菌药物预防很少是合理的,但对于频繁发生发热性尿毒症的儿童,应考虑持续使用抗菌药物预防。
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Urinary Tract Infection in Children.

Background: Urinary Tract Infection (UTI) is a common infection in children. Prompt diagnosis and appropriate treatment are very important to reduce the morbidity associated with this condition.

Objective: To provide an update on the evaluation, diagnosis, and treatment of urinary tract infection in children.

Methods: A PubMed search was completed in clinical queries using the key terms "urinary tract infection", "pyelonephritis" OR "cystitis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature and the pediatric age group. Patents were searched using the key terms "urinary tract infection" "pyelonephritis" OR "cystitis" from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com.

Results: Escherichia coli accounts for 80 to 90% of UTI in children. The symptoms and signs are nonspecific throughout infancy. Unexplained fever is the most common symptom of UTI during the first two years of life. After the second year of life, symptoms and signs of pyelonephritis include fever, chills, rigor, flank pain, and costovertebral angle tenderness. Lower tract symptoms and signs include suprapubic pain, dysuria, urinary frequency, urgency, cloudy urine, malodorous urine, and suprapubic tenderness. A urinalysis and urine culture should be performed when UTI is suspected. In the work-up of children with UTI, physicians must judiciously utilize imaging studies to minimize exposure of children to radiation. While waiting for the culture results, prompt antibiotic therapy is indicated for symptomatic UTI based on clinical findings and positive urinalysis to eradicate the infection and improve clinical outcome. The choice of antibiotics should take into consideration local data on antibiotic resistance patterns. Recent patents related to the management of UTI are discussed.

Conclusion: Currently, a second or third generation cephalosporin and amoxicillin-clavulanate are drugs of choice in the treatment of acute uncomplicated UTI. Parenteral antibiotic therapy is recommended for infants ≤ 2 months and any child who is toxic-looking, hemodynamically unstable, immunocompromised, unable to tolerate oral medication, or not responding to oral medication. A combination of intravenous ampicillin and intravenous/intramuscular gentamycin or a third-generation cephalosporin can be used in those situations. Routine antimicrobial prophylaxis is rarely justified, but continuous antimicrobial prophylaxis should be considered for children with frequent febrile UTI.

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期刊介绍: Recent Patents on Inflammation & Allergy Drug Discovery publishes review articles by experts on recent patents in the field of inflammation and allergy drug discovery e.g. on novel bioactive compounds, analogs and targets. A selection of important and recent patents in the field is also included in the journal. The journal is essential reading for all researchers involved in inflammation and allergy drug design and discovery.
期刊最新文献
Meet Our Editorial Board Member Diagnosis of Allergic Reactions to Drugs Non-steroidal Anti-inflammatory Drugs Other Antimicrobial Drugs Biologics: Monoclonal Antibodies for Non-cancer Therapy, Cytokines, Fusion Proteins, Enzymes, and Hormones
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