急性単純性膀胱炎と再発 - 化学療法後の再発判定基準について -

Abstract

女性急性単純性膀胱炎(AUC)の再発判定基準につき9種の経口抗菌薬(計270余症例)の治療後経過観察所見について臨床的に解析を加え, 下記の基準決定案を作成した.1)対象患者:投薬前に急性単純性膀胱炎におけるUTI薬効評価基準の患者条件を満足し, 規定された投薬期間投薬後に著効であった患者とする.2)投薬期間:薬効評価(3日分投薬)に使用した薬剤を同量で4日分追加し, 計7日分とする.3)休薬期間:7日間とする.4)再発判定:膿尿および細菌尿を指標とし, 膿尿10個/hpf未満かつ細菌尿104個/ml未満を再発なし, 膿尿10個/hpf以上かつ細菌尿104個/ml以上を再発ありとし, それらの中間のものはどちらとも規定しない.5)再発判定時期:7日分投薬後著効であることを確認し, 7日間の休薬後に判定する.ただし, 休薬期間中に再発が認められる場合はその時点で判定する.6)採尿法:本判定にかかわる(すなわち7日分投薬終了時以降)尿検査は中間尿で行い, 陽性所見が出ればカテーテル尿で再検査する.中間尿の採用方法は外陰部清拭(クロールヘキシジン綿)の通常の方法で行う

The recurrence of female acute uncomplicated cystitis was investigated clinically. The criteria for the evaluation of recurrences were proposed, as follows; Patients: Target infection is acute uncomplicated cystitis (AUC) which had satisfied the specifications of AUC Criteria by the UTI Committee of Japan and showed the excellent effects of an antimicrobial agent after a definite period of administration. Treatment period: Seven days; after 3 days' administration to evaluate the drug efficacy, patients shall take an additional 4 days' treatment. Interval of follow up proposed was 7 days. Evaluation of recurrence: Parameters of criteria are pyuria and bacteriuria. Recurrence: Pyuria greater than or equal to 10 WBCs/hpf and bacteriuria greater than or equal to 10(4)/ml. Evaluation of the day of recurrence: Evaluation should be made 14 days after the start of treatment. Urine sampling: After 7 days of treatment, midstream urine is collected and in cases with positive findings, catheterized urine should then be collected. Using these criteria it will be possible to evaluate and compare the ability of various antimicrobial agents to cure acute uncomplicated cystitis.