퀴놀론 내성 Escherichia coli가 원인균인 여성의 급성 단순 신우신염에 대한 초기 경험적 치료로서 ciprofloxacin의 치료효과 : 전향적 관찰 연구 = Clinical Efficacy of Ciprofloxacin in Women with Acute Uncomplicated Pyelonephritis Caused by Quinolone Resistant Escherichia coli : a Prospective Observational Study

다국어 초록 (Multilingual Abstract)

Backgrounds: Urinary tract infection (UTI) including acute pyelonephritis (APN) is one of the common infectious diseases in women. Escherichia coli (E. coli) is the most common pathogen. ciprofloxacin is recommended as the first line antibiotic regimen where trimethoprim-sulfomethoxazole (TMP-SMX) resistance rate of urinary pathogens is exceeding 10 to 20%. But there is little information about the efficacy of ciprofloxacin trreatment where ciprofloxacin resistance rate of urinary pathogens is high.
Purposes: This study was designed to reveal the clinical efficacy of empirical treatment of ciprofloxcin is different between quinolone sensitive E. coli infected women and quinolone resistant E. coli infected women who have uncomplicated APN.
Methods: All patients who has been diagnosed clinically and microbiologically as APN were enrolled. Of total 367 patients, 112 patients were excluded because of complication of APN ( abscess, urinary tract obstruction, severe sepsis), ciprofloxacin allergy, pregnancy, and breast feeding. Intravenous ciprofloxacin (400mg) was administered at first and followed by oral ciprofloxacin (500mg q 12 hours). All patient was followed up in 4 to 7 days and 22 to 42 days from first treatment day. In each follow-up day, all patients were evaluated about not only improvement of symptoms and signs but also microbiologic irradication .
Results : Finally 255 patients were included. Patients were divided to ciprofloxacin resistant group (QNR-EC) (n= 39) and ciprofloxacin sensitive group (QNS-EC) (n=216). In the first follow up, clinical cure rate of QNR-EC and QNS-EC was 76.9 (30/216)% and 87.0 (188/216)%, (p=0.135) and microbiologic cure rate was 33.3 (12/206)% and 95.1 (194/206)%, (p=0.000) respectively. In the second follow up day, the clinical cure rate was 94.9 (37/243)% in QNR-EC and 98.6 (206/243)% in QNS-EC (p=0.177).
Conclusions: Even in case of the quinolone resistant E. coli related APN, ciprofloxacin can be used empirically.

목차 (Table of Contents)

• 서론 1
• 재료 및 방법 4
• 결과 9
• 고찰 15
• 결론 및 고찰 24
• 참고문헌 34