SMITSJKDMAR

 

„Einfld" vagfrasking hj konum – Blrublga

 

Inngangur

Einfld vagfrasking er sking hj annars hraustum konum, ungum og mialdra, sem eru ekki me ekkta vagfrasjkdma, ungaar ea me endurteknar skingar.

Arar leibeiningar eiga vi um vagfraskingar hj brnum, unguum konum, krlum og einstaklingum me ekkta vagfrasjkdma, endurteknar skingar ea grun um nrnaskingu.

Ekki er nausynlegt a rkta vag, hj konum me „einfalda" vagfraskingu. Greining er klnsk me asto smsjrskounar og/ea vagstrimlils, fyrir hvtum blkornum og ntrt.

F rktun og nmisprf ef „einfld" blrublga svarar ekki mefer innan 2ja til 3ja daga Endurskoa um lei greiningu m.a.me tilliti til Chlamydia, kynfrablsturs ea sveppaskingar.


Fyrsta mefer

Sking hj annars hraustum konum, ungum og mialdra, sem ekki eru me ekkta vagfrasjkdma, ungaar ea me endurteknar skingar

trmetprm 100–200 mg x 2 dag 3 daga    
ntrfrantin 50 mg x 3 dag 3 daga Lyfið er á undanþágulista lyfjanefndar, undanþágulyfseðill nauðsynlegur  
 


nnur mefer

1. Ef rangur er viunandi en baktera nm fyrir v lyfi sem fyrst var vali, skv. rktun og nmisprfi, arf a mehndla 14 daga me sama lyfi

2. Ef baktera reynist nm er vali anna lyf samkvmt nmi en me kostna og aukaverkanir huga

amoxicilln 250 mg x 3 dag 3 daga  
amoxicillin-klavlanat 250 mg x 3 dag 3 daga  
pvmecillinam 200 mg x 3 dag 3 daga  
knln  
cefalsprn  

Athugasemdir

  • riggja daga mefer er langflestum tilvikum ngileg og henni fylgja frri aukaverkanir heldur en lengri mefer.
  • Enginn munur er nmi E.coli ea S.saphrophyticus fyrir trmetprm-slfa og trmetprm einu sr (80–88%). Nmi fyrir ntrfrantin er 96–99%.
  • Muna a ekki er mlt me ntrfrantin ef grunur er um efri vagfraskingu v ttleiki ess nrum er lgur.
  • Cefalsprnin verka svipa og trmetprm og ntrfrantin algengustu vagfraskingavalda en eru miklu drari og meiri lkur eru a au trufli elilega armaflru.

Heimildir

  1. Antibiotic Guidelines 9th Edition, January 1996 – Australia.
  2. Bailey R. A. Management of lower urinary tract infections. Drugs 1993; 45
    (Suppl. 3): 139–144.
  3. Blackstone V., Grnberg R.N. Minimum effective dose of trimethoprim for urinary tract infection. J Royal Coll Gen Pract 1988; 38: 320.
  4. British National Formulary September 1995.
  5. Brumfitt W., Hamilton-Miller J.M.T. Consensus viewpoint on management of urinary infections. Journal of Antimicrobial Chemotherapy 1994; 33 (Supp A): 147–153.
  6. Brumfitt W., Pursell R. Double-blind trial to compare ampicillin, cephalexin,
    co-trimoxazole, and trimethoprim in treatment of urinary infection. BMJ 1972; 2: 673–676.
  7. Carlson K. J., Mulley A.G. Management of acute dysuria. A decision-analysis model of alternative strategies. Annals Int Med 1985; 102: 244–249.
  8. Co-trimoxazole, or just trimethoprim? Drug and Therapeutics Bulletin 1986; 24: 17–19.
  9. Hatton J., Hughes M., Raymond C.H. Management of bacterial urinary tract infections in adults. Ann Pharmacother 1994; 28: 1264–1272.
  10. Hooton T. M., Winter C., Tiu F., Stamm W.E. Randomized comparative trial and cost analysis of 3-day antimicrobial regimens for treatment of acute cystitis in women. JAMA 1995; 273: 41–45.
  11. M. Gill. Use of sulphonamides and trimethoprim today. Prescriber Feb. 5, 1995; 55–62.
  12. Magns lafsson, Jhann g. Sigursson. Vaxandi lyfjanmi vi vagfraskingar? (Increased antimicrobial resistance in urinary tract infections?). Lknablai 1996; 82: 66–70.
  13. Nicholle L. E. Urinary tract infection in the elderly. J Antimicrob Chemother 1994; 33 (Suppl. A): 99–109.
  14. Norrby S. R. Short-term treatment of uncomplicated lower urinary tract infections in women. Reviews of Infectious Diseases 1990; 12: 458–467.
  15. Reeves D. S. A perspective on the safety of antibacterials used to treat urinary tract infections. J Antimicrob Chemother 1994; 33 (Supp. A): 111–120.
  16. Stamm W.E., Hooton T.M. Management of urinary tract infections in adults. New Engl J Med 1993; 1328–1334.
  17. Swann R. A., Clark J. Antibiotic policies – relevance to general practitioner prescribing. Journal of Antimicrobial Chemotherapy 1994; 33 (Suppl. A): 131–135.
  18. Urinary tract infection. MeReC Bulletin 1995; 6: 29–32.


Fr ritstjra:
nlegri slenskri rannskn ar sem nmi baktera var kanna kom ljs a E. Coli var skingarvaldur 83% tilfella og fullt nmi var fyrir ntrfrantin 99% en 67% fyrir ampicillin og 87% fyrir trmetoprim. Ekki var fjalla um klnsk hrif meferar og hafa verur huga a ekki fer alltaf saman nmi og verkun raun v lyfin n miklu hrri styrk vagi en hgt er a n vi nmisprf. lafsson, Magnus et al. Urinary tract infections, antibiotic resistance and sales of antimicrobial drugs: An observational study of uncomplicated urinary tract infections in Icelandic women. Scand J Prim Helath Care 2000;18:35-38.


Unni af Karli G Kristinssyni sklasrfringi, Siguri Helgasyni heimilislkni og Siguri Gumundssyni smitsjkdmasrfringi
Unni 1997