Профілактика інфекційних хвороб сечових шляхів у вагітних
Бічна панель сторінки статті
Основний зміст сторінки статті
Анотація
Інфекції сечових шляхів – одне з найпоширеніших інфекційних захворювань у світі. Період вагітності зумовлює як маніфестацію, так і рецидиви захворювань сечових шляхів. Серед вагітних інфекційні захворювання сечових шляхів діагностують приблизно у 2–15%, вони підвищують частоту акушерських ускладнень, таких як передчасні пологи та низька маса тіла при народженні.
У статті представлено огляд останніх наукових публікацій, які присвячені питанню профілактики інфекцій сечових шляхів у вагітних. З цією метою у більшості країн світу, в тому числі європейських, рекомендується проводити бактеріологічне дослідження сечі, що також регламентовано наказом Міністерства охорони здоров’я України. За виявлення безсимптомної бактеріурії вагітній призначають антибіотикопрофілактику інфекції сечових шляхів.
У публікації розглянуто питання вибору антибактеріального препарату, особливу увагу приділено антибіотикорезистентності. Інфекції сечових шляхів – найпоширеніша причина призначення антибіотиків вагітним, а розвиток резистентності до антибіотиків є небезпечним як для вагітної, так і для плода.
Крім розвитку резистентності, проблеми, пов’язані з використанням антимікробних препаратів, включають недотримання пацієнтками режиму лікування, виникнення потенційних побічних ефектів (як у матері, так і у плода) та вплив на загальну ефективність лікування. Усе це потенціює альтернативні методи профілактики як рецидивної бактеріурії, так і інфекцій сечових шляхів.
Альтернативою повторному призначенню антибіотиків або з метою запобігання рецидиву при стійкій бактеріурії та рецидивних інфекціях сечовивідного тракту, особливо, якщо із сечі виділяють Escherichia coli (80–85% серед всіх уропатогенів), може бути призначення препаратів, що містять D-манозу, журавлину, їхню комбінацію з іншими уро- або імунопротекторними засобами.
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Посилання
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