Title: Updated Guidelines for Acute Uncomplicated Cystitis in Women
题目：女性急性无合并症膀胱炎治疗的新指南
Author作者: Bryan Hayes

In 2011, updated treatment guidelines were published for acute uncomplicated cystitis and pyelonephritis in women. The recommendations differ from the previous iteration due to increased E. Coli resistance.
2011年发表了女性急性无合并症膀胱炎治疗的新指南。由于大肠杆菌耐药性的增加，新的指南和过去的有所不同。
Cystitis (recommendations in order of preference)
膀胱炎（按推荐顺序）
1. Nitrofurantoin 100 mg BID X 5 days
呋喃妥因 100 mg ，一天两次，共五天
2. Bactrim DS 1 tab BID X 3 days (not recommended when resistance rate is > 20%)
复方新诺明，1片，一天两次，共三天（如耐药率超过20％就不要用了）
3. Fosfomycin
磷霉素
4. Fluoroquinolonesnot recommended as first-line therapy due to “propensity for collateral damage”
由于氟喹诺酮类的副作用而不做为第一线推荐药
5. Beta-lactam agents, including amoxicillin-clavulanate, cefdinir, cefaclor, and cefpodoxime-proxetil, in 3–7-day regimens are appropriate choices for therapy when other recommended agents cannot be used. Other beta-lactams, such as cephalexin, are less well studied but may also be appropriate in certain settings.
包括奥格门汀，头孢地尼，头孢克罗，头孢泊肟酯在内的3－7天β-内酰胺类抗生素方案在无其它药可用的情况下，也可考虑。对其它的β-内酰胺类抗生素，如头孢胺苄，的研究不多，在某种情况下也可应用。

Take home points:
要点：
• Be familiar with your institution’s antibiogram
• 要熟悉本院的抗菌谱
• Use nitrofurantoin first-line for uncomplicated cystitis in women (it is contraindicated with CrCl< 60 mL/min)
• 对女性没有合并症的膀胱炎首选呋喃妥因（肌酐清除率低于每分钟60毫升时不要用）
• Consider beta-lactams such as Augmentin or Vantin (cefpodoxime) in patient’s with kidney injury
• 如病人有肾损伤，可用奥格门汀或头孢泊肟
•
References参考文献

Gupta K, et al. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical Infectious Diseases 2011;52(5):e103-e120.