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尿路感染(UTI)及男性生殖细菌性感染是最常见的微生物感染性疾病之一,在临床抗菌化疗领域占有相当大的比重。在了解抗生素药动学和药效学性质的基础上,非复杂性膀胱炎、非复杂性肾盂肾炎、复杂性UTI以及生殖感染的临床分类有助于临床医师选择合理的抗生素治疗方案。为了降低现有抗生素的压力,磷霉素氨基丁三醇、呋喃妥英和匹美西林已被作为治疗非复杂性膀胱炎的专属抗生素。复杂性UTI的致病菌谱广,如敏感则可选用β-内酰胺类、氟喹诺酮类、氨基糖苷类或复方磺胺甲噁唑等多种抗生素进行治疗。用于治疗生殖感染(如前列腺炎)的抗生素应该具备良好的相关药动学性质(如氟喹诺酮和大环内酯类),同时非典型致病菌衣原体或支原体的敏感性也是必需要考虑的因素。
Urinary tract infections (UTIs) and male reproductive bacterial infections are one of the most common microbial infections and account for a significant share of clinical antimicrobial chemotherapy. Based on an understanding of the pharmacokinetic and pharmacodynamic properties of antibiotics, the clinical classification of non-complex cystitis, non-complex pyelonephritis, complex UTI, and genital infections can help clinicians choose a rational antibiotic regimen. In order to reduce the pressure of existing antibiotics, fosfomycin trometamol, nitrofurantoin and pimecillin have been used as exclusive antibiotics for the treatment of non-complex cystitis. Complex UTI bacterial spectrum broad, such as the sensitivity can choose to use β-lactams, fluoroquinolones, aminoglycosides or sulfamethoxazole and other antibiotics for treatment. Antibiotics for the treatment of genital infections (such as prostatitis) should have good pharmacokinetic properties (such as fluoroquinolones and macrolides), and the susceptibility of the atypical pathogens Chlamydia or Mycoplasma is also a must factor.