成人女子急性単純性膀胱炎と各種抗菌剤の治療成績

Abstract

Acute simple bacterial cystitis in female adults has been utilized for evaluation of effect of antimicrobial drugs on urinary tract infection. More exactly to choose the lesion from other similar conditions without cystoscopic examination, its clinical manifestations were surveyed. 301 well-documented female adults were classified into acute simple cystitis (119 patients, 39.5%, 38.8±14.1 years old), chronic cystitis (68 patients, 22.6%, 47.9±14.9 years old) and "cystitissimulating syndrome" (114 patients, 37.9%, 42.7 ± 13.0 years old) on cystoscopic findings. "Cystitis-simulating syndrome" here means a condition in which a patient complains of bladder irritating symptoms but cystoscopic findings are negative, and, in practice, includes irritable bladder, nervous pollakisuria, bladder neurosis, psychosomatic cystitis, endocrine cystopathy and so on. 1) 89.9% of the patients with acute simple cystitis, 26.5% with chronic cystitis and only 4.4% with "cystitis-simulating syndrome" saw us in a week after the onset of a symptom. 2) Only 5.0% of the patients with acute simple cystitis complained of sense of residual urine or discomfort during miction alone. On the other hand, patients with the same complaint amounted to 36.8% in the group of chronic cystitis and 62.3% in the other group. The majority of patients who complained of severe miction pain or severe pollakisuria belonged to the category of acute simple cystitis. 3) Urinalysis showed negative on white blood cells in urinary sediment in 85.1 % of the patients with "cystitis-simulating syndrome" and in 41.2% of the patients with chronic cystitis. More than 30 white blood cells a high-power field were counted in 62.2% of the patients with acute simple cystitis. 4) 76% of acute simple cystitis were proved to be bacterial. Urine culture yielded Gram negative rods in 33% of the patients with chronic cystitis and in 10% of the patients with "cystitissimulating syndrome". The majority of the isolates were E. coli. The effect of the drugs was analysed after thiophenicol, sulfamethoxazole-trimethoprim, aminocyc10hexylpenicillin and nalidixic acid were given for three days to each group of 21 to 25 patients with acute simple bacterial cystitis. 65.2% of the TP group, 95.7% of the ST group, 85.7% of the AC-PC group and 92.0% of the NA group were evaluated as effective. The effect of ST or NA was proved significantly better than that of the other drugs.