Atencion primaria · 2002
[Rational use of medications in the treatment of urinary infections].
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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León González E, Calderón Ubeda J, Hernández Martín P, Rodríguez Martínez B, Merino Segovia R, Gil García M
Аннотация
OBJECTIVES: MAIN: to encourage the rational use of medication in the treatment of uncomplicated acute cystitis (UAC). SECONDARY: to find the most common germs in our area and their sensitivity to medication, the most common anti-microbials used and patients age, and to evaluate the savings made through a policy of rational use of medication.Design. Retrospective, descriptive, observational study.
SETTING: La Solana Health Centre jointly with the biochemistry laboratory of the Talavera Area.
PARTICIPANTS: Probabilistic randomised sampling of clinical histories of women between 20 and 80 with episodes of UAC (349 in all) between 01/10/95 and 01/10/00.
MEASUREMENTS AND RESULTS: First, the laboratory evaluated 591 urine cultures of complicated/uncomplicated UTI from 01/01/00 to 01/10/00, with study of the germs involved and their sensitivities. 373 positives were isolated: E. coli (78.3%), which had the greatest sensitivity to amoxycillin/clavulanic acid, fosfomycin, nitrofurantoin and cefixime; Proteus (7.2%) and Streptococcus D (5.8%). Second, clinical records were analysed for the following: antibiotics (norfloxacine and cyprofloxacine, the most common); length of treatment (average of 6.52.34 days); age of patient (greater number in under-65s).
CONCLUSIONS: E. coli is the most common germ in UTI and is highly sensitive to amoxy/clavulanic acid, nitrofurantoin, fosfomycin and cefixime. Resistance to cyprofloxacine and norfloxacine are starting to be significant. In UAC the three-day model should be encouraged for young women; and 7 days is recommended for the over-65s. More rational use of medication would increase efficacy and suppose a considerable economic saving in our area.
SETTING: La Solana Health Centre jointly with the biochemistry laboratory of the Talavera Area.
PARTICIPANTS: Probabilistic randomised sampling of clinical histories of women between 20 and 80 with episodes of UAC (349 in all) between 01/10/95 and 01/10/00.
MEASUREMENTS AND RESULTS: First, the laboratory evaluated 591 urine cultures of complicated/uncomplicated UTI from 01/01/00 to 01/10/00, with study of the germs involved and their sensitivities. 373 positives were isolated: E. coli (78.3%), which had the greatest sensitivity to amoxycillin/clavulanic acid, fosfomycin, nitrofurantoin and cefixime; Proteus (7.2%) and Streptococcus D (5.8%). Second, clinical records were analysed for the following: antibiotics (norfloxacine and cyprofloxacine, the most common); length of treatment (average of 6.52.34 days); age of patient (greater number in under-65s).
CONCLUSIONS: E. coli is the most common germ in UTI and is highly sensitive to amoxy/clavulanic acid, nitrofurantoin, fosfomycin and cefixime. Resistance to cyprofloxacine and norfloxacine are starting to be significant. In UAC the three-day model should be encouraged for young women; and 7 days is recommended for the over-65s. More rational use of medication would increase efficacy and suppose a considerable economic saving in our area.