中国全科医学2017，Vol.20Issue(18)：2241-2245,5.DOI:10.3969/j.issn.1007-9572.2017.04.y12
呋喃妥因治疗老年肠球菌下尿路感染的疗效分析
Effect of Nitrofurantoin on Lower Urinary Tract Infection Due to Enterococcus in Old People
摘要
Abstract
Background Urinary tract infection(UTI) can be commonly caused by enterococcus which is a type of gram-positive bacteria with high antibiotic resistance.Vancomycin(VAN) or linezolid(LZD) is often used for clinical treatment of UTI,but the economic burden is heavy to the individuals.In contrast,nitrofurantoin(NIT) is an effective,inexpensive and easily available drug for acute and chronic UTI basically without causing the resistance of enterococcus proved by a 50-year history of clinical application.However,there are few reports about using NIT to treat lower urinary tract infection(LUTI) due to enterococcus in old people.Objective To evaluate the clinical efficacy and safety of NIT in the treatment of elderly patients with LUTI due to enterococcus,so as to provide an evidence for clinical treatment of the disease.Methods This retrospective study was conducted between July 2009 and July 2015.The participants recruited were 92 consecutive LUTI outpatients and inpatients meeting the inclusion criteria from the Affiliated Hospital of Clinical Medical College of Panzhihua University,Central Hospital of Panzhihua,and Pangang Group General Hospital,including 52 cases of simple LUTI and 40 cases of complicated LUTI.The results of bacterial culture and drug sensitivity test were recorded.All patients were given the 7-14 d treatment of orally taking NIT enteric coated tablets 100 mg,qid.The clinical treatment response,status of enterococcus eradication and adverse reactions in the patients were recorded.Results It was found that 60 patients(65.2%) were infected by enterococcus faecalis,and other 32(34.8%) were infected by enterococcus faecium.Both kinds of bacteria were not resistant to NIT,VAN,and LZD,and they had no significant difference in the rate of resistance to ampicillin(AMP),penicillin G(PEN),ampicillin/sulbactam(SAM),erythromycin(ERY),levofloxacin(LEV) and high-concentration gentamicin(GEN)(P>0.05).The overall response rate was 84.8%(78/92).Patients with simple LUTI had higher response rate than those with complicated LUTI 〔96.2%(50/52) vs.70.0%(28/40),x.2=11.987,P<0.001〕.The overall enterococcus eradication rate was 81.5%(75/92).Patients with simple LUTI had higher enterococcus eradication rate than those with complicated LUTI 〔96.2%(50/52) vs.62.5%(25/40),x.2=11.256,P=0.027〕.Of the 92 patients,22 cases(23.9%) had nausea,vomiting,and mild diarrhea,but relieved after symptomatic treatment without stopping the NIT treatment.No patients had cough,asthma,rash,peripheral neuritis and other adverse reactions.Conclusion NIT has good clinical efficacy in the treatment of elderly patients with LUTI due to enterococcus without heavy economic burden and many adverse reactions during short-term oral administration.It is especially suitable for elderly patients with simple LUTI and can be used as the first-choice drug for these patients.关键词
呋喃妥因/肠球菌属/泌尿道感染/老年人/治疗结果Key words
Nitrofurantoin/Enterococcus/Urinary tract infections/Aged/Treatment outcome分类
医药卫生引用本文复制引用
朱冬菊,吴祥,杨科..呋喃妥因治疗老年肠球菌下尿路感染的疗效分析[J].中国全科医学,2017,20(18):2241-2245,5.基金项目
四川省教育厅2015年度自然科学一般项目(15ZB0422)--攀枝花地区肠球菌尿路感染的细菌分布及耐药性分析 （15ZB0422）
攀枝花学院校级课题(2014YB51)--攀枝花肠球菌尿路感染的耐药性及危险因素分析 （2014YB51）
