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由甲氧苄啶/磺胺甲恶唑引起的尿路感染及长期治疗

Urinary Tract Infections Caused by and Prolonged Treatment with Trimethoprim/Sulfamethoxazole.

作者信息

Filev Rumen, Lyubomirova Mila, Bogov Boris, Kolevski Alexander, Pencheva Victoria, Kalinov Krasimir, Rostaing Lionel

机构信息

Department of Nephrology, Internal Disease Clinic, University Hospital "Saint Anna", 1750 Sofia, Bulgaria.

Faculty of Medicine, Medical University Sofia, 1504 Sofia, Bulgaria.

出版信息

Microorganisms. 2025 Feb 14;13(2):422. doi: 10.3390/microorganisms13020422.

Abstract

Urinary tract infections (UTIs) are among the most prevalent bacterial infections, with emerging as a significant multidrug-resistant pathogen, particularly in healthcare settings. The frequent utilization of β-lactams and fluoroquinolones has contributed to the reduced clinical application of trimethoprim-sulfamethoxazole (TRS). Nevertheless, this reduced use may have preserved its efficacy as a second-line therapy. The aim of this study is to determine whether TRS can be a cost-effective long-term solution for patients with multidrug-resistant UTIs. This study evaluated the effectiveness of a structured, long-term TRS regimen in 11 patients with recurrent UTIs who had failed at least two prior antibiotic treatments. Patients were carefully selected, and the collected data were analyzed using descriptive analysis. The findings demonstrated microbiological eradication and symptomatic relief in all patients, with only one case of a delayed allergic reaction. All patients had a negative urine microbiology analysis after at least two unsuccessful treatment attempts over a period of 6 to 18 months. These results underscore TRS's potential as a cost-effective and efficient second-line treatment, particularly in settings with limited therapeutic options. Its affordability, manageable side effect profile, and ability to target biofilm-associated infections further highlight its therapeutic value.

摘要

尿路感染(UTIs)是最常见的细菌感染之一,作为一种重要的多重耐药病原体正在出现,尤其是在医疗环境中。β-内酰胺类药物和氟喹诺酮类药物的频繁使用导致甲氧苄啶-磺胺甲恶唑(TRS)的临床应用减少。然而,这种使用减少可能保留了其作为二线治疗的疗效。本研究的目的是确定TRS是否可以成为多重耐药UTIs患者具有成本效益的长期解决方案。本研究评估了一种结构化的长期TRS方案对11例复发性UTIs患者的有效性,这些患者之前至少两次抗生素治疗均失败。对患者进行了仔细筛选,并使用描述性分析对收集的数据进行了分析。结果显示所有患者的微生物均被根除且症状缓解,仅1例出现延迟过敏反应。在6至18个月的时间里,所有患者在至少两次治疗失败后尿液微生物学分析均为阴性。这些结果强调了TRS作为一种具有成本效益且高效的二线治疗的潜力,尤其是在治疗选择有限的情况下。其可承受性、可管理的副作用以及针对生物膜相关感染的能力进一步凸显了其治疗价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3bf/11858204/02158dadb0e8/microorganisms-13-00422-g001.jpg

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