WONCA研究论文摘要汇编——无并发症尿路感染女性患者推迟抗生素治疗的意愿:一项前瞻性队列研究

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背景女性在发现急性尿路感染(UTI)症状后,常采用抗生素治疗。然而,25%~50%有尿路感染症状的女性没有使用抗生素治疗,症状在1周内自行消失。尚不了解有多少女性愿意推迟抗生素治疗。研究者采用全科医生询问方式,调查有多少有UTI症状的女性愿意推迟抗生素治疗。方法 2006-04-18—2008-10-08开展了一项前瞻性队列研究,入选患者来自于荷兰阿姆斯特丹市内及周围20家全科医生诊所。对因7 d内尿疼和/或尿频看全科医生的健康、非妊娠女性,记录她们的症状并且收集尿液做尿液分析和培养。尿液培养结果回报前,请全科医生询问所有患者是否愿意推迟抗生素治疗。7 d后,请患者报告他们的症状是否有缓解,是否用了抗生素。结果共176名女性,全科医生要求其中137名女性推迟抗生素治疗,其中37%(51/137)愿意推迟抗生素治疗。1周后,55%(28/51)愿意推迟抗生素治疗的女性仍未使用抗生素,其中有71%(20/28)报告症状好转或痊愈。参试女性无一例发生肾盂肾炎。结论全科医生询问时,1/3有UTI症状的女性愿意推迟抗生素治疗。1周后,大多数推迟抗生素使用的女性报告症状自行缓解。 Background Women often use antibiotics after finding symptoms of acute urinary tract infection (UTI). However, 25% to 50% of women with symptoms of urinary tract infection are not treated with antibiotics and their symptoms disappear within a week. It is unknown how many women are willing to postpone antibiotic treatment. The investigators used a general practitioner inquiry to investigate how many women with UTI symptoms were willing to postpone antibiotic therapy. METHODS: A prospective cohort study was conducted from April 18, 2006 to June 8,2008, and selected patients were from 20 general practitioner clinics in and around Amsterdam, the Netherlands. For healthy, nonpregnant women who have general practitioners who have had urinary and / or urinary frequency within 7 days, their symptoms are recorded and urine collected for urine analysis and culture. Before returning urine culture results, ask a general practitioner to ask all patients whether they would like to postpone antibiotic treatment. After 7 days, ask patients to report whether their symptoms have been alleviated or whether antibiotics have been used. RESULTS: A total of 176 women were required by general practitioners to postpone antibiotics in 137 of them, and 37% (51/137) were willing to postpone antibiotic treatment. After one week, 55% (28/51) of women who were willing to postpone antibiotic treatment did not yet use antibiotics, of which 71% (20/28) reported improvement or recovery. None of the female participants had pyelonephritis. Conclusions When questioned by a general practitioner, one in three women with UTI symptoms are willing to delay antibiotic treatment. One week later, most women who postponed their use of antibiotics reported that they had their symptoms relieved.
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