Post-intercourse versus daily ciprofloxacin prophylaxis for recurrent urinary tract infections in premenopausal women
Post-intercourse versus daily ciprofloxacin prophylaxis for recurrent urinary tract infections in premenopausal women
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DOI：
10.1016/s0022-5347(01)65087-0
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发表时间：
1997-03-01
影响因子：
6.6
通讯作者：
Naber, KG
中科院分区：
文献类型：
--
作者：
Melekos, MD;Asbach, HW;Naber, KG
目的：我们评估和比较了性交后和每日口服环丙沙星预防135例性活跃的绝经前妇女反复下尿路感染的疗效。材料和方法：性交后（组1，70例）和每日（组2，65例）预防方案125 mg。环丙沙星开始后，治愈性，传统的治疗最初的急性尿路感染。预防措施维持12个月，在此期间，对患者进行临床和细菌学随访，并采集尿液和阴道样本。在预防性治疗结束后，对患者进行了为期一年的随访。而第1组和第2组中每例患者分别有3.67例和3.74例尿路感染发生在相应预防性治疗方案开始前12.2个月的相同平均时间内，在预防期间，组1中每名患者仅发生0.043例感染，组2中每名患者仅发生0.031例感染（P < 0.0001）。预防性治疗前，86%的阴道前庭培养物产生革兰氏阴性肠杆菌，两个治疗组之间平均分布，而性交后和每日预防性治疗期间分别为5.6%和2.5%。预防治疗结束后，每例患者泌尿系感染发生率和肠道革兰氏阴性菌肠道定植率总体改善，平均感染发生率为0.44/例患者（发生在总患者人群的34%），而36%的所有女性有异常的阴道定植。长期性交后预防与环丙沙星被证明是同样有效的日常预防，和前者的治疗的主要优势是使用的药物消耗量的三分之一，在日常预防。
Purpose: We evaluated and compared the efficacy of post-intercourse and daily oral ciprofloxacin prophylaxis against recurrent lower urinary tract infections in 135 sexually active premenopausal women.Materials and Methods: Post-intercourse (group 1, 70 patients) and daily (group 2, 65 patients) prophylactic regimens of 125 mg. ciprofloxacin were started following a curative, conventional treatment of the initial acute urinary tract infection. Prophylaxis was maintained for 12 months and during this period patients were followed clinically and bacteriologically with urine and introital samples. Patients were subsequently followed for an additional year after the end of preventive treatment.Results: While 3.67 urinary tract infections per patient in group 1 and 3.74 in group 2 occurred during an identical mean time of 12.2 months before start of the corresponding prophylactic regimen, only 0.043 infection per patient in group 1 and 0.031 in group 2 developed during prophylaxis (p < 0.0001). Before prophylaxis 86% of the vaginal vestibule cultures yielded gram-negative Enterobacteriaceae, equally distributed between both treatment arms, compared to 5.6% and 2.5% during postcoital and daily prophylaxis, respectively. The overall improvement in the incidence of the urinary infections per patient and the rate of introital colonization with enteric gram-negative bacteria was maintained after the end of prophylaxis, with a mean incidence of infections of 0.44 per patient (occurring in 34% of the total patient population), while 36% of all women had abnormal introital colonization.Conclusions: Long-term post-intercourse prophylaxis with ciprofloxacin proved to be equally effective as daily prophylaxis, and the major advantage of the former therapy was use of only a third of the amount of drug consumed in daily prophylaxis.