Infants under two months of age with urinary tract infections are showing increasing resistance to empirical and oral antibiotics

Segal, Zvi; Cohen, Matan J.; Engelhard, Dan; Tenenbaum, Ariel; Simckes, Ari M.; Benenson, Shmuel; Stepensky, Polina; Averbuch, Diana

doi:10.1111/apa.13322

Cited by 7 publications

(8 citation statements)

References 28 publications

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“…15 Previous studies have demonstrated the significant differences between Enterococcus and gram-negative pathogens in febrile infants, including differences in gestational age, resistance patterns, pyuria, and urinary tract abnormalities. 6,14,16,17 Our findings of variation in LOS compared with gram-negative pathogens substantiates previous findings differences in clinical course of Enterococcus UTIs. 16…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

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

Antoon

Reilly

Munns

et al. 2019

Global Pediatric Health

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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.

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Section: Discussionsupporting

confidence: 91%

“…6 Despite evolving resistance patterns to UTI, susceptibility to empiric treatment remained very high across all clinical groups. 6,14 Our findings of satisfactory empiric coverage of young infants with UTIs mirror those of febrile infants and infants with febrile UTI <90 days of age. 6…”

Section: Discussionmentioning

confidence: 57%

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

Antoon

Reilly

Munns

et al. 2019

Global Pediatric Health

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“…Few studies are available on patients aged under 3 months. Segal et al reported that E. coli was isolated in 76.4% of UTIs that occurred in infants younger than 2 months, followed by Klebsiella pneumoniae and Enterobacter cloacae in 13.8% and 1.9% of cases, respectively [ 33 ]. Pseudomonas aeruginosa was isolated only in 0.9% of infants.…”

Section: Resultsmentioning

confidence: 99%

Management of Pediatric Urinary Tract Infections: A Delphi Study

et al. 2022

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Urinary tract infection (UTI) is one of the most common infectious diseases in the pediatric population and represents a major cause of antibiotic consumption and hospitalization in children. Considering the ongoing controversies on the management of pediatric UTI and the challenges due to increasing antimicrobial resistance, the aim of the present study was to evaluate the level of agreement on UTI management in pediatric age in Emilia-Romagna Region, Italy, and to assess on the basis of recent studies whether there is the need to change current recommendations used by primary care pediatricians, hospital pediatricians, and pediatric surgeons in everyday clinical practice to possibly improve outcomes. This consensus provides clear and shared indications on UTI management in pediatric age, based on the most updated literature. This work represents, in our opinion, the most complete and up-to-date collection of statements on procedures to follow for pediatric UTI, in order to guide physicians in the management of the patient, standardize approaches, and avoid abuse and misuse of antibiotics. Undoubtedly, more randomized and controlled trials are needed in the pediatric population to better define the best therapeutic management in cases with antimicrobial resistance and real usefulness of long-term antibiotic prophylaxis.

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“…Despite being a natural consequence of antibiotic therapy, resistance to this type of drugs has been growing [2]. A responsibility for increasing resistances has been attributed to an also increasingly easier access to this medication; in addition, this induced a more frequent prescription, most of the times by less informed health practitioners and hence a wider usage in a larger range of infectious conditions [3]. All these sequential facts had favoured the development of microbial strains resistant to the most commonly used antibiotics [2].…”

Section: Introductionmentioning

confidence: 99%

“…All these sequential facts had favoured the development of microbial strains resistant to the most commonly used antibiotics [2]. This upsurge of resistance is a proven fact, shown by its emergence at an earlier age [3], as is the adequacy of the therapeutic decision the current concern of physicians [4]. Simultaneously, there has been a distinct reduction in production of new classes of antimicrobial drugs.…”

Section: Introductionmentioning

confidence: 99%

The Incidence of Exposure to Antibiotics in Children Less Than 6 Years of Age: A Survey in a Portuguese Metropolitan Area

Machado¹,

Marafona²,

Meireles³

et al. 2016

J Preg Child Health

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Background: The contact with antibiotics at an early age may lead to a number of nefarious consequences. Nevertheless, the amount of literature available on the usage of antibiotics in children is scarce. Taking into account the increasing emergence of resistant bacterial strains, it is imperative to study and make society aware of the excessive exposure of children to antibiotics. The purpose of this study was to evaluate the incidence of antibiotic therapy in children under the age of six, in the metropolitan area of Oporto.

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Infants under two months of age with urinary tract infections are showing increasing resistance to empirical and oral antibiotics

Abstract: Resistance to antibiotics challenges empirical therapy and compromises oral treatment options in young infants with UTIs. Antimicrobial resistance patterns should be monitored in infants to determine appropriate empirical antibiotic therapy protocols.

Cited by 7 publications

References 28 publications

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

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

Management of Pediatric Urinary Tract Infections: A Delphi Study

The Incidence of Exposure to Antibiotics in Children Less Than 6 Years of Age: A Survey in a Portuguese Metropolitan Area

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