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现有预防非妊娠期妇女膀胱炎复发的临床证据如下①连续预防性使用抗生素一系列随机对照试验研究表明,连续预防性使用抗生素(甲氧苄氨嘧啶、复方磺胺甲噁唑、呋喃妥英、头孢克洛或一种喹啉)6~12个月可以减少复发性膀胱炎的发生率,但各种不同用药方案间未发现感染率有差异。一个比较持续性每日使用抗生素与性交后使用抗生素的随机对照试验表明,1年后尿培养阳性率差异无统计学意义。②性交后预防性使用抗生素(复方磺胺甲噁唑、呋喃妥英或一种喹啉)4个随机对照试验研究表明,性交后2h内使用复方磺胺甲噁唑、呋喃妥英或喹啉较安慰剂能显著降低膀胱炎发生率。一个关于性交后预防性使用抗生素和每日连续使用抗生素的随机对照试验发现,1年后二者的膀胱炎发生率的差异无统计学意义。③一次性使用复方磺胺甲噁唑一个小样本随机对照试验发现,连续每日预防性使用复方磺胺甲噁唑与在膀胱炎症状出现后一次性使用复方磺胺甲噁唑相比,前者能显著降低膀胱炎发生率。但由于证据太有限,不能得出肯定结论。④酸果蔓汁(cranberry juice)和酸果蔓制品一个系统评价发现,酸果蔓汁及其制品能预防复发性膀胱炎的证据不足。⑤用马尿酸乌洛托品预防缺乏研究马尿酸乌洛托品的可靠的随机对照试验。
The current clinical evidence to prevent the recurrence of cystitis in nonpregnant women is as follows: (1) Continuous Preventive Use of Antibiotics A series of randomized controlled trials have shown that continuous prophylactic use of antibiotics (trimethoprim, sulfamethoxazole, nitrofurantoin, Cefaclor or a quinoline) 6 to 12 months can reduce the incidence of recurrent cystitis, but no difference between the various drug regimens found infection rates. A more consistent daily use of antibiotics and use of antibiotics after sexual intercourse randomized controlled trials showed that one year after the urine culture positive rate was no significant difference. Preventive use of antibiotics after sexual intercourse (compound sulfamethoxazole, nitrofurantoin or a quinoline) four randomized controlled trials showed that within 2h after sexual intercourse using the compound sulfamethoxazole, nitrofurantoin or quinoline more comfort Agents can significantly reduce the incidence of cystitis. A randomized controlled trial of prophylactic use of antibiotics and continuous daily use of antibiotics after sexual intercourse found no significant difference in the incidence of cystitis after 1 year. ③ one-time use of compound sulfamethoxazole A small randomized controlled trial found that continuous daily use of compound sulfamethoxazole in children with symptoms of cystitis after a one-time use of compound sulfamethoxazole compared to the former can be significantly reduced Cystitis incidence. However, due to the limited evidence, no positive conclusion can be drawn. (4) A systematic review of cranberry juice and cranberry products found that there is insufficient evidence that cranberry juice and its products prevent recurrent cystitis. ⑤ urotropin with hippuric acid prophylaxis Lack of reliable study of urotropin hippurate reliable randomized controlled trials.