Febrile urinary tract infection in children: ampicillin and trimethoprim insufficient as empirical mono-therapy

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Martina PrelogLothar Bernd Zimmerhackl

Abstract

The aim of this study was to characterize the pathogens and their antibiotic susceptibilities in defined groups of children (total number 694) with urinary tract infection (UTI) regarding age, first UTI (FUTI) or recurrent UTI (RUTI), renal abnormalities or vesico-ureteric reflux (VUR) in order to optimize empirical antibiotic therapy and prophylaxis. In patients aged between 1 month and 24 months with a first febrile UTI (FUTI; n = 205) the leading pathogen was Escherichia coli (E. coli) (83.4%). In comparison with patients with FUTI, those with RUTI (n = 24) had more Enterococcus and Enterobacter infections and higher resistance rates of E. coli against trimethoprim (TMP), trimethoprim/sulfamethoxazole (SXT) or ampicillin (AMP). Boys with ultrasound-detected renal abnormalities (n = 71) showed 14.2% Pseudomonas and 59.1% E. coli infections versus girls (n = 48) (2.1% Pseudomonas and 93.7% E. coli). Of 390 patients who underwent voiding cysto-urethrography, 31.5% had VUR. Of them, 45.5% received antimicrobial prophylaxis with SXT (n = 30) or cefazolin (n = 26). There was no difference between girls (n = 242) and boys (n = 148) regarding the frequency of VUR and pathogens. There were more TMP- and SXT-resistant E. coli cultures...Continue Reading

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Citations

Jan 24, 2013·Der Urologe. Ausg. A·R Beetz, F Wagenlehner
Jul 29, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Maria BitsoriEmmanouil Galanakis
Mar 17, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Sermin A Saadeh, Tej K Mattoo
Apr 20, 2011·The Pediatric Infectious Disease Journal·Khalid IsmailiMichelle Hall
Jun 29, 2011·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Tanja IlićMarijan Saraga
Dec 24, 2013·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Maria BitsoriEmmanouil Galanakis
Nov 1, 2011·International Journal of Antimicrobial Agents·Rolf Beetz, Martin Westenfelder
Aug 17, 2010·The Journal of Pediatrics·Khalid IsmailiMichelle Hall
Jul 21, 2009·Seminars in Nephrology·Lorraine E Bell, Tej K Mattoo
Jul 7, 2015·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·H P DuongK Ismaili
Dec 30, 2009·Acta Microbiologica Et Immunologica Hungarica·M SzászK Nagy
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Oct 17, 2018·Journal of Paediatrics and Child Health·Jus RakhraHasantha Gunasekera
Aug 12, 2009·Expert Opinion on Pharmacotherapy·Albert Bensman, Tim Ulinski

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