Comparison of Trimethoprim-Sulfamethoxazole, Cephadroxil and Cefprozil as Prophylaxis for Recurrent Urinary Tract Infections in Children

Abstract

The aim of this study was to compare the efficacy of prophylactic trimethoprim-sulfamethoxazole (TMP/SMZ), cefprozil and cephadroxil treatments in children who have recurrent urinary tract infection, but no urinary tract pathology. After acute urinary tract infections (UTIs) were treated, the patients were divided into 3 groups randomly and TMP/SMZ was given to 21 patients, cephadroxil was given to 25 patients and cefprozil was given to 34 patients for 3 months--one dose at night. All patients were followed for 6 months following prophylaxis. The frequency of symptomatic UTIs among groups during prophylaxis was not statistically different, however the number of symptomatic UTIs in the cephadroxil group was lower than the other groups. Asymptomatic bacteriuria episodes were detected in TMP/SMZ and cefprozil groups, whereas no asymptomatic bacteriuria episodes were seen in the cephadroxil group. The number of patients with symptomatic UTI during the follow-up period was not different between groups, however all the asymptomatic bacteriuria episodes were encountered in the cefprozil group. In conclusion, in this study cephadroxil was found to be slightly superior to TMP/SMZ and cefprozil in preventing asymptomatic bacteriuria episodes and symptomatic UTIs in children with recurrent UTI and normal urinary tract system.

Antimicrobial Pharmacotherapy Management of Urinary Tract Infections in Pediatric Patients

“…Few studies have compared the effectiveness of different antibiotics in preventing recurrent UTIs in children. [93][94][95][96][97] Nitrofurantoin was found to be more effective than trimethoprim-sulfamethoxazole in patients with urological abnormalities and young patients aged 1 to 5 years with normal urinary tract system. 93,94 Other studies that included patients without urinary tract abnormalities showed that nitrofurantoin was as efficacious as trimethoprim, cefixime, and pivmecillinam (an extendedspectrum penicillin, not available in the United States).…”

Prevalence of community acquired urinary tract infections in silchar medical college, Assam, India and its antimicrobial susceptibility profile

“…[7] Over the years, treatment of urinary tract infection (UTI) has thrown up a lot of challenges due to the increasing level of antimicrobial resistance. [8] Varying and high levels of multiple resistance of uropathogenic Enterococcus species and other urinary bacterial isolates to quite a large number of antibiotics commonly used in treatment of UTIs, have been encountered. Effective management of these infections is often hampered by the lack of adequate facilities for proper microbial isolation as well as for their antimicrobial susceptibility testing.…”

Antibiotic Resistance Patterns of Community-Acquired Urinary Tract Infections in Children With Vesicoureteral Reflux Receiving Prophylactic Antibiotic Therapy

“…5,6 Trials in Japan and Turkey showed that low-dose cephalosporin treatment could effectively reduce the risk of recurrent UTIs in children. 7,8 These results suggest that cephalosporins can be an alternative choice for prophylactic treatment. Antibiotic prophylaxis with cephalosporins for VUR has been favored by many pediatric nephrologists and urologists in Japan 7 and elsewhere, including Taiwan.…”