【AUA指南更新】女性复发性单纯性尿路感染

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1.Clinicians should obtain acomplete patient history and perform a pelvic examination in women presenting with rUTIs.(Clinical Principle)

1.临床医生应该要对出现反复尿道感染的女性收集完整的病史并进行盆腔的检查。（临床原则）

2.To make a diagnosis of rUTI,clinicians must document positive urine cultures associated with prior symptomatic episodes.(Clinical Principle)

2.要做出反复尿路感染的诊断，临床医生需证实阳性尿培养与之前症状的发作相关。（临床原则）

3.Clinicians should obtain repeat urine studies when an initial urine specimen is suspect for contamination,with consideration for obtaining a catheterized specimen.(Clinical Principle)

3.当怀疑初始尿样受到污染时，临床医生应考虑通过导尿获得样本进行重复的尿液检查。（临床原则）

4.Cystoscopy and upper tract imaging should not be routinely obtained in the index patient presenting with rUTI.(Expert Opinion)

4.膀胱镜检及上尿路成像不应常规应用于出现反复尿路感染的病人。（专家意见）

5.Clinicians should obtain urinalysis,urine culture and sensitivity with each symptomatic acute cystitis episode prior to initiating treatment in patients   with rUTIs.(Moderate Recommendation;Evidence Level:Grade C)

5.对于反复尿路感染的病人，在初始治疗之前，临床医生就应对每一例有症状的急性膀胱炎发作患者进行尿液分析，尿液培养和敏感性检查。（合理的建议；证据级别：C 级）

6.Clinicians may offer patient-initiated treatment (self-starttreatment) to select rUTI patients with acute episodes while awaiting urine cultures.(Moderate Recommendation;Evidence Level:Grade C)

6.在等候尿培养时，临床医生可以提供病人初始的治疗（自我启动治疗）挑选出反复尿道感染并急性发作的患者。（合理的建议；证据级别：C 级） 

无症状细菌尿

7.Clinicians should omit surveillance urine testing,including urine culture,in asymptomatic patients with r UTIs. (Moderate Recommendation;Evidence Level:Grade C)

7.临床医生应该避免对无症状性反复尿路感染患者进行尿检监测以及尿培养。（合理的建议；证据级别：C 级）

8.Clinicians should not treat ASB in patients.(Strong Recommendation ；Evidence Level:Grade B)

8.临床医生不应该对无症状性菌尿患者进行治疗。（强烈建议；证据级别：B 级）

抗生素治疗

9.Clinicians should use first-line therapy (i.e., nitrofurantoin, TMP-SMX, fosfomycin) dependent on the local antibiogram for the treatment of symptomatic UTIs in women.

(Strong Recommendation;Evidence Level:Grade B)

9.临床医生应该依据局部抗菌谱使用一线治疗药物（比如:呋喃妥因、复方新诺明、磷霉素)治疗有症状的尿道感染的女性。（强烈建议；证据级别:B 级）

10.Clinicians should treat rUTI patients experiencing acute cystitis episodes with as short a duration of antibiotics as reasonable, generally no longer than seven days.

(Moderate Recommendation;Evidence Level: Grade B)

10.对于反复尿道感染患者急性膀胱炎发作，临床医生应该合理选择短程治疗，一般不超过七天。（合理的建议；证据级别：B 级）

11.In patients with rUTIs experiencing acute cystitis episodes as sociated with urine cultures resistant to oral antibiotics,clinicians may treat with culture-directed parenteral antibiotics for as short a course as reasonable, generally no longer than seven days.(Expert Opinion)

11.与尿培养相关的急性膀胱炎发作的反复尿路感染患者，出现口服抗菌药耐药，临床医生可采用尿培养为导向的肠道外的合理的短程抗生素治疗，一般不超过七天。（专家意见）

12.Following discussion of the risks,benefits,and lternatives, clinicians may  rescribe antibiotic prophylaxis to decrease the risk of future UTIs in women of all ages previously diagnosed with UTIs.(Moderate  Recommendation; Evidence Level:Grade B)

12.在对风险、益处和替代方案进行讨论之后，临床医生可以开出抗生素的预防处方，以降低先前诊断为反复尿道感染的所有年龄段的女性未来患该病的风险。（合理的建议；证据级别：B 级）

13.Clinicians may offer cranberry prophylaxis for women with rUTIs.(Conditional Recommendation;Evidence Level:Grade C)

13.临床医生可建议使用蔓越莓制剂来预防女性泌尿系感染的反复发作。(有条件的建议；证据级别：C 级)

14.Clinicians should not perform a post-treatment test of cure urinalysis or urine culture in asymptomatic patients.（Expert Opinion)

14.临床医师不应对无症状患者进行常规尿液检查或尿培养及药敏试验及治疗。（专家意见） 

15.Clinicians should repeat urine cultures to guide further management when UTI symptoms persist  following  antimicrobial therapy.(Expert Opinion)

15.当在目前抗菌素治疗时，尿路感染症状仍持续，临床医生应重复尿培养来指导进一步治疗。（专家意见）

16.In peri-and post-menopausal women with rUTIs,clinicians should recommend vaginal estrogen therapy to reduce the risk of future UTIs if there is no contraindication to estrogen therapy.(Moderate  Recommendation; Evidence Level:Grade B)

16.在围绝经期和绝经后的反复尿道感染妇女，如果没有雌激素治疗的禁忌症，临床医生应建议阴道雌激素疗法来降低未来尿路感染的风险。（合理的建议；证据级别：B 级）

*翻译仅供学习交流，不作为临床实践标准