|
Quelle:
Medline Abstract
Blaseninfektion
bei Frauen: 3-Tage-Antibiotika-Therapie
reicht lediglich aus, um die Beschwerden zu beseitigen
Blasen- und Harnwegsinfekte sind bei Frauen aufgrund ihrer kurzen
Harnröhre weit verbreitet. In der letzten Zeit empfehlen immer
mehr Ärzte bei Blaseninfektionen eine Antibiotika-Kurztherapie.
Da dies der unter Experten weit verbreiteten Ansicht widerspricht,
daß eine Antibiotika-Therapie ausreichend lang – also eine Woche
und länger - durchgeführt werden sollte, hat eine israelische
Wissenschaftler-Gruppe die vorhandene wissenschaftliche Datenbasis
analysiert. Anhand der Daten von nahezu 10.000 Frauen stellten
sie fest, daß eine 3-Tage-Therapie zwar tatsächlich ausreicht,
um die lästigen Symptome wie vermehrtes Wasserlassen zu beseitigen.
Wenn es aber darum geht die auslösenden Bakterien langfristig
zu beseitigen ist es besser, die Antibiotika - wie früher üblich
- über einen längeren Zeitraum einzunehmen.
Three-day vs longer duration of antibiotic treatment for cystitis
in women: systematic review and meta-analysis.
J Med. 2005 Nov;118(11):1196-207.
Katchman EA, Milo G, Paul M, Christiaens T, Baerheim A, Leibovici
L.
Department of Medicine E, Rabin Medical Center, Beilinson Campus,
Petah-Tiqva, Israel.
PURPOSE: We performed a meta-analysis to ascertain the efficacy
and safety of the currently practiced 3-day antibiotic therapy
for cystitis versus prolonged therapy (5 days or longer) to relieve
symptoms and to achieve bacteriological cure.
METHODS: The Cochrane Library, the Cochrane Renal Group's Register
of trials, EMBASE and MEDLINE were searched to identify all randomized
controlled trials comparing 3-day oral antibiotic therapy with
prolonged therapy (5 days and longer) for uncomplicated cystitis
in adult non-pregnant women. Two reviewers independently applied
selection criteria, performed quality assessment, and extracted
data. Relative risks (RR) with their 95% confidence intervals
(CI) were estimated; a fixed effect model was used. An intention-to-treat
analysis was performed whenever possible.
RESULTS: Thirty-two trials and 9605 patients met inclusion criteria.
For symptomatic failure rates no difference between 3-day and
prolonged antibiotic regimens was found at short term (RR 1.16,
95% CI: 0.96-1.41) and long-term follow-up (RR 1.17, 95% CI: 0.99-1.38).
Three-day treatment was less effective than prolonged therapy
in preventing bacteriological failure, relative risk 1.37 (95%
CI: 1.07-1.74) for short-term follow-up, and 1.47 (95% CI: 1.22-1.77)
for long-term follow-up. Adverse effects were more common in the
prolonged therapy group (RR 0.83, 95% CI: 0.79-0.91). The results
were consistent for subgroup and sensitivity analyses.
CONCLUSION: Antibiotic therapy for 3 days is similar to prolonged
therapy in achieving symptomatic cure for cystitis, while the
prolonged treatment is more effective in obtaining bacteriological
cure.
|
