Document Detail


Is combination antimicrobial therapy required for urinary tract infection in children?
MedLine Citation:
PMID:  12741735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This retrospective study examined the characteristics of 338 pediatric patients presenting with a first episode of symptomatic urinary tract infection at Taichung Veterans General Hospital from November 1996 to December 2001. Escherichia coli was the most common pathogen (72.5%), followed by Proteus mirabilis (8.3%), Enterococcus (5.6%), and Klebsiella pneumoniae (4.7%). They were more susceptible to first-generation cephalosporin in comparison with other first-line antimicrobial agents such as trimethoprim/sulfamethoxazole, ampicillin, and gentamicin. Two hundred and eighty-seven (84.9%) of the 338 patients were divided into 3 groups according to the type of antibiotic treatment received, and the susceptibility rate and the averaged day of defervescence after effective antibiotic therapy were compared among the groups. Group 1 consisted of those patients treated with cefazolin or cephalexin alone (95%, 2.1 days); Group 2, cefazolin plus gentamicin (88.9%, 2.8 days); and Group 3, ampicillin plus gentamicin (76.1%, 2.3 days). A total of 38 (13.2%) cases from the 3 antibiotic groups did not respond to empiric antibiotics. For non-susceptible infections, when the antibiotic regimen was switched from cefazolin plus gentamicin to ampicillin alone, only 4 (20%) strains became susceptible, compared with 10 strains (62.5%) becoming susceptible after switching from ampicillin plus gentamicin to cefazolin alone (p < 0.01). The results indicated that first-generation cephalosporin alone is an appropriate treatment for pediatric cases of community-acquired urinary tract infection and suggest that antimicrobial combinations should be reserved for serious or critical cases.
Authors:
Kun-Chia Lu; Po-Yen Chen; Fang-Liang Huang; Hsiu-Wen Yu; Chia-Hui Kao; Lin-Shien Fu; Chin-Shiang Chi; Yeu-Jun Lau; Jen-Fu Lin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi     Volume:  36     ISSN:  1684-1182     ISO Abbreviation:  J Microbiol Immunol Infect     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-05-13     Completed Date:  2003-07-25     Revised Date:  2007-06-21    
Medline Journal Info:
Nlm Unique ID:  100956211     Medline TA:  J Microbiol Immunol Infect     Country:  China (Republic: 1949- )    
Other Details:
Languages:  eng     Pagination:  56-60     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anti-Bacterial Agents / pharmacology,  therapeutic use*
Child
Child, Preschool
Drug Therapy, Combination / therapeutic use*
Escherichia coli / drug effects
Female
Humans
Infant
Infant, Newborn
Klebsiella pneumoniae / drug effects
Male
Microbial Sensitivity Tests
Proteus mirabilis / drug effects
Retrospective Studies
Urinary Tract Infections / drug therapy*,  microbiology*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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