Efficacy of Empiric Treatment of Urinary Tract Infections in Neonates and Young Infants

Abstract

Background . The antibiotic resistance patterns of young infants with urinary tract infections (UTIs) have evolved over the past 2 decades. Whether current empiric antibiotic regimens are sufficient in this age group is unknown. Methods . A retrospective review of patients aged 0 to 60 days admitted with a UTI discharge diagnosis. Results . Overall susceptibility to empiric antibiotics was 87%. Antibiotic resistance and length of stay were highest among those who were afebrile, those admitted to the intensive care unit, and those with culture diagnosis of enterococcal infection. The sensitivity and specificity of ultrasound as a screening tool for genitourinary anomaly was 70% and 40%, respectively, with a positive predictive value of 31.8%. Conclusions . Empiric antibiotic regimens cover a high percentage of UTIs in infants. However, high rates of resistance and prolonged length of stay in patients with enterococcal infection highlight the need for continued surveillance of such patients in this age group.

Ampicillin‐sulbactam monotherapy in infants with febrile urinary tract infections

“…Urinary tract infections are the most common bacterial infections in children, 1,2 and, if not treated early and properly, complications such as renal scarring, end‐stage renal failure, or hypertension may occur 3,4 . The most frequently isolated pathogens in children are E. coli (75–90%), followed by Klebsiella spp., Proteus spp., and Enterococcus spp 2,5–7 . In this study, E. coli was the most common isolated pathogen in both groups (93.5%, 75.6%).…”

“…3,4 The most frequently isolated pathogens in children are E. coli (75-90%), followed by Klebsiella spp., Proteus spp., and Enterococcus spp. 2,[5][6][7] In this study, E. coli was the most common isolated pathogen in both groups (93.5%, 75.6%). A number of earlier studies on susceptibility have been conducted in Korea.…”