İdrar yolu enfeksiyonlu çocuklarda sefiksim tedavisinin idrar NAG atılımına etkisi
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Tarih
2004
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İdrar yolu enfeksiyonu (İYE) çocukluk çağının en sık bakteriyel enfeksiyonlarından biridir. Üçüncü jenerasyon sefalosporinler arasında yer alan ve geniş antibakteriyal spektruma sahip olan sefiksimin İYE'nun oral yoldan tedavisinde etkinliği kanıtlanmıştır. Bu çalışmada İYE'lu çocuklarda sefiksimin idrar elektrolit atılımları ve proksimal tübüler fonksiyo¬nun duyarlı bir göstergesi olan N-asetil-beta-D-glukozaminidaz (NAG) atılımına etkisinin araştırılması amaçlanmıştır. Çalışmaya İYE tanısı konan ve sefiksim tedavisi başlanan yaşlan 5-156 ay arasında değişen (medyan yaş: 72 ay) 24 kız, 2 erkek İYE'lu çocuk çalışma grubu olarak alınırken; kontrol grubu olarak son bir ay içinde antibiyotik kullanmamış olan 17 çocuk (yaş dağılımı 8-156 ay arasında, medyan yaş 82 ay, 6 kız, 11 erkek) alınmıştır. İYE'lu hastaların sefiksim tedavisi öncesi ve 10 günlük tedaviden sonra, ayrıca kontrol grubunun açlık spot ilk idrar örneklerinde sodyum, potasyum, kalsiyum, magnezyum, ürik asit, fosfor (Na, K, Ca, Mg, Ürik Asit, P) düzeyleri ve NAG aktiviteleri ölçülerek sonuçlar idrar kreatinine (Kre) oranlanarak hesaplanmıştır. İdrar NAG aktivite ölçümü idrara jel filtrasyonu uygulandıktan sonra paranitrofenol yöntemi ile yapılmıştır. Kontrol grubu ile tedavi öncesi hasta grubunun sonuçlan non-parametrik, Mann Whitney U testi ile; hasta grubunun tedavi öncesi ve tedavi sonrası değerleri Wilcoxon Signed Ranks testi ile karşılaştınlmıştır.Çalışmanın sonuçlarında spot idrarda Na, K, Ca, Ürik Asit, Mg, P'un idrar kreatinine oranları ve NAG/Kre oranları İYE'lu çocuklarda tedavi öncesinde kontrol grubuna oranla farklı bulunmamıştır (p>0,05). İdrar elektrolit ve NAG atılımları da hasta grubunda tedavi sonrasında tedavinin başlangıç düzeylerine oranla farklı değildi (p>0,05).Sonuç olarak, oral yoldan günde tek doz olarak kullanılan ve bu şekilde tedavi uyumu yüksek olan sefiksimin renal tübüler fonksiyonlarda değişiklik yaratmadığı saptandı. Bu sonucun tedavinin güvenilirliğinin belirlenmesi açısından önemli olduğu düşünüldü.
Urinary tract infections are one of the most common bacterial infections of childhood. Efficacy of cefixime, which is a third generation cephalosporin, is proven in oral treatment of urinary tract infections. the aim of this study was to evaluate the effect of cefixime, which was shown to accumulate in renal tissue at high concentrations, on the excretion of N-acetyl-beta-D-gThe study group consisted of 26 children (age range 5-156 months, median age 72 month, 24 female) who received cefixime treatment for urinary tract infection. Control group was composed of 17 children (age range 8-156 months, median age 82 month, 6 female) whose mean age was similar to that of the patient group and who had not received antibiotics in the last month. Sodium, potassium, calcium, magnesium, uric acid, phosphorus (Na, K, Ca, Mg, UA, P) and NAG levels were measured in the first morning fasting urine in the patients before and 10 days after treatment as well as in the control group and the results were calculated by dividing these values by the urinary creatinine (Cr). Urinary levels of the NAG enzyme were measured via the paranitrophenol method after gel filtration. Results of the control and pretreatment group were compared by the Mann Whitney U test. Pre- and post-treatment urinary electrolyte and urinary NAG results were compared by the Wilcoxon Signed Ranks test.Ratio of urinary Na, K, Ca, uric acid, Mg, P and NAG to creatinin in the pretreatment group were not found to be different from those of the control group (p>0,05). Similarly, excretion of electrolytes and NAG did not change significantly after treatment when compared to those before treatment (p>0,05).As a conclusion, cefixime, which has single oral daily dosage and therefore high patient compliance, was detected not to cause changes in renal tubular functions. This result was thought to be important in determination of the safety of the treatment.lucosaminidase (NAG) that is a sensitive marker of proximal tubular functions.
Urinary tract infections are one of the most common bacterial infections of childhood. Efficacy of cefixime, which is a third generation cephalosporin, is proven in oral treatment of urinary tract infections. the aim of this study was to evaluate the effect of cefixime, which was shown to accumulate in renal tissue at high concentrations, on the excretion of N-acetyl-beta-D-gThe study group consisted of 26 children (age range 5-156 months, median age 72 month, 24 female) who received cefixime treatment for urinary tract infection. Control group was composed of 17 children (age range 8-156 months, median age 82 month, 6 female) whose mean age was similar to that of the patient group and who had not received antibiotics in the last month. Sodium, potassium, calcium, magnesium, uric acid, phosphorus (Na, K, Ca, Mg, UA, P) and NAG levels were measured in the first morning fasting urine in the patients before and 10 days after treatment as well as in the control group and the results were calculated by dividing these values by the urinary creatinine (Cr). Urinary levels of the NAG enzyme were measured via the paranitrophenol method after gel filtration. Results of the control and pretreatment group were compared by the Mann Whitney U test. Pre- and post-treatment urinary electrolyte and urinary NAG results were compared by the Wilcoxon Signed Ranks test.Ratio of urinary Na, K, Ca, uric acid, Mg, P and NAG to creatinin in the pretreatment group were not found to be different from those of the control group (p>0,05). Similarly, excretion of electrolytes and NAG did not change significantly after treatment when compared to those before treatment (p>0,05).As a conclusion, cefixime, which has single oral daily dosage and therefore high patient compliance, was detected not to cause changes in renal tubular functions. This result was thought to be important in determination of the safety of the treatment.lucosaminidase (NAG) that is a sensitive marker of proximal tubular functions.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Ege Tıp Dergisi
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Cilt
43
Sayı
2
