头孢菌素在治疗下尿路感染中的地位

A. V. Kuzmenko, V. Kuzmenko, T. A. Gyaurgiev
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引用次数: 0

摘要

治疗下尿路感染(LUTI),如膀胱炎或无症状细菌性尿症,通常在实践中被证明是一项比乍一看更困难的任务。抗菌药物的选择应考虑其疗效、临床研究证明、耐受性、不良事件以及其成本和可获得性。流行病学研究的许多结果表明,尿路病原体对抗生素的耐药性稳步增加,这反过来又导致无效治疗和复发疾病形式的病例数量增加。在选择抗生素时,应优先选择耐药微生物选择风险低和产生附带损害风险低的药物,如推荐作为一线治疗药物的磷霉素和硝基呋喃。根据目前的联邦临床指南,建议使用第三代头孢菌素作为LUTI的替代疗法,包括孕妇,过敏,不耐受,根据细菌测试对病原体缺乏敏感性或以前用一线药物治疗无效。本文介绍了第三代头孢菌素治疗LUTI疗效的文献资料。关键词:膀胱炎,下尿路感染,尿路病原体,头孢菌素,头孢克肟,临床推荐。引用本文:Kuzmenko a.v., Kuzmenko v.v., Gyaurgiev T.A.头孢菌素在治疗下尿路感染中的地位。俄罗斯医学调查。2023;7(4):212-217。DOI: 10.32364 / 2587-6821-2023-7-4-212-217。
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The place of cephalosporins in the treatment of lower urinary tract infection
Therapy of lower urinary tract infections (LUTI), such as cystitis or asymptomatic bacteriuria, commonly turns out to be a more difficult task in practice than it seems at first glance. The choice of antibacterial drugs should be made taking into account their efficacy, proven in clinical studies, tolerability, adverse events, as well as their cost and availability. Numerous results of epidemiological studies indicate a steady increase in the resistance of uropathogens to antibiotics, which, in turn, leads to an increase in the number of cases of ineffective therapy and recurrent disease forms. When choosing an antibiotic, preference should be given to drugs with a low selection risk of resistant microorganisms and collateral damage development, such as fosfomycin and nitrofurans recommended as first-line therapy drugs. According to the current federal clinical guidelines, third-generation cephalosporins are recommended for use as an alternative therapy for LUTI, including in pregnant women, in allergies, intolerance, lack of sensitivity of the pathogen according to bacteria tests or previous ineffective treatment with first-line drugs. This article presents the literature data on the efficacy of the third-generation cephalosporin use in the treatment of LUTI. KEYWORDS: cystitis, lower urinary tract infection, uropathogens, cephalosporins, cefixime, clinical recommendations. FOR CITATION: Kuzmenko A.V., Kuzmenko V.V., Gyaurgiev T.A. The place of cephalosporins in the treatment of lower urinary tract infection. Russian Medical Inquiry. 2023;7(4):212–217 (in Russ.). DOI: 10.32364/2587-6821-2023-7-4-212-217.
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