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Piperacillin-Tazobactam versus Cefotaxime as Empiric Treatment for Febrile Urinary Tract Infection in Hospitalized Children.

Authors :
Kyoung Hee Han
Min-su Oh
Jungmin Ahn
Juyeon Lee
Youn Woo Kim
Young Mi Yoon
Yoon-Joo Kim
Hyun Sik Kang
Ki-Soo Kang
Greenbaum, Larry A.
Jae Hong Choi
Source :
Infection & Chemotherapy. Jun2024, Vol. 56 Issue 2, p266-275. 10p.
Publication Year :
2024

Abstract

Background: According to international pediatric urinary tract infection (UTI) guidelines, selecting ampicillin/ sulbactam or amoxicillin/clavulanate is recommended as the first-line treatment for pediatric UTI. In Korea, elevated resistance to ampicillin and ampicillin/sulbactam has resulted in the widespread use of third-generation cephalosporins for treating pediatric UTIs. This study aims to compare the efficacy of piperacillin-tazobactam (TZP) and cefotaxime (CTX) as first-line treatments in hospitalized children with UTIs. Materials and Methods: The study, conducted at Jeju National University Hospital, retrospectively analyzed medical records of children hospitalized for febrile UTIs between 2014 and 2017. UTI diagnosis included unexplained fever, abnormal urinalysis, and the presence of significant uropathogens. Treatment responses, recurrence, and antimicrobial susceptibility were assessed. Results: Out of 323 patients, 220 met the inclusion criteria. Demographics and clinical characteristics were similar between TZP and CTX groups. For children aged ≥3 months, no significant differences were found in treatment responses and recurrence. Extended-spectrum beta-lactamase (ESBL)-positive strains were associated with recurrence in those <3 months. Conclusion: In Korea, escalating resistance to empirical antibiotics has led to the adoption of broad-spectrum empirical treatment. TZP emerged as a viable alternative to CTX for hospitalized children aged ≥3 months with UTIs. Consideration of ESBL-positive strains and individualized approaches for those <3 months are crucial. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20932340
Volume :
56
Issue :
2
Database :
Academic Search Index
Journal :
Infection & Chemotherapy
Publication Type :
Academic Journal
Accession number :
178258550
Full Text :
https://doi.org/10.3947/ic.2024.0020