Pediatria pre prax 4/2014

The effect of sequential antibiotic treatment with cephalosporins of acute pyelonephritis

Guidelines for treatment of urinary tract infections (UTI) have undergone significant changes in recent years. Despite some rules there is still significant individuality in selection, duration and rout of administration of the antibiotic therapy. The aim of the study was to assess the success of sequential 14-day-long sequential antibiotic treatment of third-generation cephalosporins (ceftizoxime and in the cefixime) in 141 children with uncomplicated acute pyelonephritis and to determine the spectrum of strains of E. coliresistance to antibiotics. Our preferred antibiotic treatment was effective in 95 % of patients. Only in 7 cases (5 %) we changed the empiric treatment. In all cases Enterococcus specieswas proven in the urine, which is naturally resistant to cephalosporins. The greatest resistance of strains of E. coli was recorded to aminopenicilins (80 %). The incidence of recurrence after our treatment during the 6 month follow-up was only 8,2 %. Our results suggest, that sequential treatment with cephalosporins is highly effective (95 %) in the treatment of acute pyelonephritis. Persistently low resistance to these agents allows their excellent therapeutic potential. The length of antibiotic treatment may be crucial in preventing recurrences of infections of the upper urinary tract UTI.

Keywords: urinary tract infections, sequential antibiotic treatment.