窄谱抗生素治疗男性急性膀胱炎的回顾性纵向研究。

IF 2.3
Egill Snaebjörnsson Arnljots, Denny Björk, Gunnar Jacobsson, Peter Ulleryd, Ronny Gunnarsson, Christina Åhren, Pär-Daniel Sundvall
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引用次数: 0

摘要

背景:男性急性膀胱炎患者从氟喹诺酮类药物转向窄谱抗生素可减少抗生素耐药性,但可能增加并发症的发生率。本研究旨在评估男性急性膀胱炎患者选择窄谱抗生素的并发症(继发性事件)风险。方法:这是一项对瑞典Västra Götaland地区所有成年男性居民进行的队列研究,随访8年,代表530万男性人年。对2012年1月至2019年12月期间至少发生一次急性膀胱炎的年龄≥18岁男性患者(n = 38,864)进行比值比(OR)和伤害所需数(NNH)分析,分析使用窄谱抗生素与广谱氟喹诺酮类药物在30天内引起继发性事件的风险。结果:参与者发生了58402例急性膀胱炎和13300例继发性事件。参与者的平均年龄为67岁(标准差17,四分位数范围58-79)。使用哌美西林(OR 1.3, p = 0.019, NNH 440)或呋喃酮(OR 1.6, p)治疗男性急性膀胱炎患者肾盂肾炎的风险较高。结论:窄谱抗生素治疗男性急性膀胱炎患者肾盂肾炎发生率的增加非常小,治疗失败或复发/再感染的增加中等。在我们看来,这并不能促使所有患有急性膀胱炎的男性都开氟喹诺酮类药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Narrow-spectrum antibiotics to male patients with acute cystitis - a retrospective longitudinal study.

Background: A transition from fluoroquinolones to narrow-spectrum antibiotics in male patients with acute cystitis could reduce antibiotic resistance but may increase the incidence of complications. This study aimed to evaluate risks with choosing narrow spectrum-antibiotics in male patients with acute cystitis for the subsequent risks for complications (secondary events).

Methods: This was a cohort study of all male adult residents in Region Västra Götaland, Sweden followed for eight years representing 5.3 million male person years. Male patients aged ≥18 years with acute cystitis at least once from January 2012 to December 2019 (n = 38,864) were analysed with Odds Ratio (OR) and Number Needed to Harm (NNH) for using narrow-spectrum antibiotics versus broad-spectrum fluoroquinolones to cause secondary events within 30 days.

Results: Participants suffered 58,402 acute cystitis and 13,300 secondary events. The mean age of participants was 67 years (SD 17, interquartile range 58-79). The risk of pyelonephritis was higher if treated with pivmecillinam (OR 1.3, p = 0.019, NNH 440) or nitrofurantoin (OR 1.6, p < 0.001, NNH 220) at the initial cystitis compared with fluoroquinolones. Non-serious secondary events, such as treatment failure or relapse/reinfection of acute cystitis, were more common if any antibiotic other than fluoroquinolones were prescribed (OR 1.5-2.4 and NNH 5.8-14).

Conclusions: Narrow-spectrum antibiotics for acute cystitis in male patients resulted in a very small increase in the incidence of pyelonephritis and a moderate increase in treatment failure or relapse/reinfection. In our opinion this does not motivate prescribing fluoroquinolones to all men with acute cystitis.

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