短疗程左氧氟沙星治疗适于重症UTI

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急性肾盂肾炎
Shorter-Course Levofloxacin Therapy Suitable for Serious UTI

NEW YORK (Reuters Health) Feb 29 - A 5-day course of levofloxacin is at least as effective as a 10-day course of ciprofloxacin for treating acute pyelonephritis and complicated urinary tract infections (UTIs), note researchers from Ortho-McNeil Pharmaceuticals, which markets levofloxacin in the US as Levaquin.

纽约（路透社 健康）2月29日－Ortho-McNei制药公司，也就是目前在美国销售左氧氟沙星的公司的研究者发现，对于治疗急性肾盂肾炎和复杂型尿路感染（UTIs），使用五天为一个疗程的左氧氟沙星和使用十天为一个疗程的希普欣的效果类似。

Fluoroquinolones are typically used to combat UTIs because they are cleared by the kidneys. The recommended course of treatment with these agents is 14 days for a complicated UTI and 7 to 14 days for acute pyelonephritis, according to the report in the January issue of Urology.

因为氟喹诺酮是通过肾脏被清除的，所以它被作为是对抗UTIs的一线药物。根据一月出版的泌尿学杂志报道，对复杂型UTI使用这个药物推荐的疗程是14天，对急性肾盂肾炎是7～14天。

Senior author Dr. Janet Peterson and colleagues point out that in addition to being more convenient, a shorter course of therapy could reduce selective pressure on the infecting pathogen and thereby decrease the risk of emerging drug resistance.

资深作者JanetPeterson和他的同事指出，使用短疗程治疗的方法的好处不仅仅在于更方便，它还可以降低要选择针对感染源的药物的压力从而降低出现抗药性的危险。

The investigators also point out that levofloxacin has a safety and tolerability profile that allows the drug to be given at increased doses. By raising the daily dose, they hoped to be able to shorten the duration of therapy required to treat a UTI.

调查者还指出，左氧氟沙星的安全和耐受特点可以允许增加使用它的剂量。通过增加每日的用量，他们希望可以缩短治疗UTI的疗程。

The researchers randomized 1109 patients to receive either levofloxacin, 750 mg/day for 5 days, or ciprofloxacin 400 mg or 500 mg twice daily for 10 days. The study population comprised 619 patients with confirmed complicated UTI or pyelonephritis and 506 who were \"microbiologically evaluable.\"

研究者让1109名患者随机接受治疗，一部分是使用左氧氟沙星，每天750mg，连续5天；一部分是使用希普欣，每天400mg或500mg，每日两次，连续10天。这1109个患者中619名患者被明确诊断为复杂型UTI或是肾盂肾炎，506名患者为镜下确诊的。

In the patients with confirmed UTI or pyelonephritis, the infection eradication rates were comparable: 79.8% with levofloxacin and 77.5% with ciprofloxacin. Eradication rates in the microbiologically evaluable population were 88.3% with levofloxacin and 86.7% with ciprofloxacin. No significant difference in clinical outcomes was noted between the groups.

在确诊为UTI或是肾盂肾炎的患者中，感染源清除率分别为：左氧氟沙星79.8％和希普欣77.5％。在镜下诊断的患者中，感染源清除率分别为：左氧氟沙星88.3％和希普欣86.7％。这两组患者的临床治疗效果没有明显差异。

These findings support the use of a 5-day course of levofloxacin as a suitable alternative to 10 days of ciprofloxacin for treating acute pyelonephritis and complicated UTIs, the researchers conclude.

研究者由此推断，这些发现都支持在治疗急性肾盂肾炎和复杂型UTIs时，可以把五天一个疗程的使用左氧氟沙星治疗作为10天一个疗程的希普欣治疗的可替代疗法。

Urology 2008;71:17-22.
国内喹诺酮耐药率还是蛮高的