임신부에서 무증상 세균뇨와 방광염 치료에 사용되는 항생제

무증상 여성에서 세균뇨의 정의는

2회 연속 voiding urine, 같은 세균 배양 ≥10^5 cfu/mL 또는 1회 catheterized urine, 세균 배양≥ 10^2 cfu/mL으로 정의하지만

실제 임상에서 2회 confirmatory voiding urine culture를 시행하지 않고

voiding 1회만으로 진단 후 치료를 개시합니다.

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임신부 방광염 또는 무증상 세균뇨에서 사용할 수 있는 항생제는

beta-lactams, nitrofurantoin, fosfomycin입니다.

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Antibiotics for asymptomatic bacteriuria and cystitis in pregnancy

Antibiotic	Dose	Duration	Notes
Nitrofurantoin	100 mg orally every 12 hours	Five to seven days	Does not achieve therapeutic levels in the kidneys so should not be used if pyelonephritis is suspected. Avoid use during the first trimester and at term if other options are available.
Amoxicillin	500 mg orally every 8 hours or 875 mg orally every 12 hours	Five to seven days	Resistance may limit its utility among gram-negative pathogens.
Amoxicillin-clavulanate	500 mg orally every 8 hours or 875 mg orally every 12 hours	Five to seven days	​
Cephalexin	250 to 500 mg orally every 6 hours	Five to seven days	​
Cefpodoxime	100 mg orally every 12 hours	Five to seven days	​
Fosfomycin	3 g orally as single dose	​	Does not achieve therapeutic levels in the kidneys so should not be used if pyelonephritis is suspected.
Trimethoprim-sulfamethoxazole	800/160 mg (one double strength tablet) every 12 hours	Three days	Avoid during the first trimester and at term.

The durations listed in the table are based on data from studies conducted in both nonpregnant and pregnant women.

 

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REF. UpToDate 2020.08.29

네이버 지식백과, 약학정보원