Prevalence of Urinary Tract Infection in Childhood

Shaikh, Nader; Morone, Natalia E.; Bost, James E.; Farrell, Max H.

doi:10.1097/inf.0b013e31815e4122

Cited by 758 publications

(631 citation statements)

References 31 publications

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“…[10][11][12] Race was dichotomized into white versus nonwhite and insurance status was categorized into private versus nonprivate because of sample size limitations. Private insurance included those with health maintenance organization and preferred provider organization coverage.…”

Section: Measurementsmentioning

confidence: 99%

National Ambulatory Antibiotic Prescribing Patterns for Pediatric Urinary Tract Infection, 1998–2007

Copp¹,

Shapiro

Hersh

2011

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:Urinary tract infections represent a significant source of exposure to antibiotics in the pediatric population and often physicians must select the antibiotic treatment empirically. No examination of ambulatory antibiotic prescribing patterns in the United States for children with urinary tract infections has been performed. WHAT THIS STUDY ADDS:Ambulatory care physicians commonly prescribe broad-spectrum antibiotics, especially third-generation cephalosporins, for the treatment of pediatric urinary tract infections. Given that narrower-spectrum alternatives are frequently appropriate options for the treatment of these infections, efforts are necessary to promote more judicious antibiotic prescribing for pediatric urinary tract infections.abstract OBJECTIVE: The goal of this study was to investigate patterns of ambulatory antibiotic use and to identify factors associated with broad-spectrum antibiotic prescribing for pediatric urinary tract infections (UTIs). METHODS:We examined antibiotics prescribed for UTIs for children aged younger than 18 years from 1998 to 2007 using the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. Amoxicillin-clavulanate, quinolones, macrolides, and second-and third-generation cephalosporins were classified as broad-spectrum antibiotics. We evaluated trends in broad-spectrum antibiotic prescribing patterns and performed multivariable logistic regression to identify factors associated with broad-spectrum antibiotic use. RESULTS: Antibiotics were prescribed for 70% of pediatric UTI visits. Trimethoprim-sulfamethoxazole was the most commonly prescribed antibiotic (49% of visits). Broad-spectrum antibiotics were prescribed one third of the time. There was no increase in overall use of broadspectrum antibiotics (P ϭ .67); however, third-generation cephalosporin use doubled from 12% to 25% (P ϭ .02). Children younger than 2 years old (odds ratio: 6.4 [95% confidence interval: 2.2-18.7, compared with children 13-17 years old]), females (odds ratio: 3.6 [95% confidence interval: 1.6 -8.5]), and temperature Ն100.4°F (odds ratio: 2.9 [95% confidence interval: 1.0 -8.6]) were independent predictors of broadspectrum antibiotic prescribing. Race, physician specialty, region, and insurance status were not associated with antibiotic selection. CONCLUSIONS: Ambulatory care physicians commonly prescribe broad-spectrum antibiotics for the treatment of pediatric UTIs, especially for febrile infants in whom complicated infections are more likely. The doubling in use of third-generation cephalosporins suggests that opportunities exist to promote more judicious antibiotic prescribing because most pediatric UTIs are susceptible to narrower alternatives. To our knowledge, no previous study has examined ambulatory antibiotic prescribing patterns in the United States for children with UTIs. Studies in the adult literature have demonstrated an increase in the use of broad-spectrum antibiotics for UTIs, 4-6 raising concerns that unnecessar...

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Section: Measurementsmentioning

confidence: 99%

National Ambulatory Antibiotic Prescribing Patterns for Pediatric Urinary Tract Infection, 1998–2007

Copp¹,

Shapiro

Hersh

2011

Pediatrics

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“…La prevalencia de ITU en los circuncidados entre los 6 y los 12 meses fue de un 0,3%, mientras que en los no circuncidados fue de un 7,3%. No se encontró información en los mayores de 1 año 6 . Estos estudios demuestran que la estrechez prepucial es un factor determinante en la ITU de los lactantes, por lo tanto, se debería instruir a las madres para mantener un buen aseo de la zona y proponer un tratamiento defi nitivo para evitar la recurrencia de ITU, especialmente en los menores de 1 año.…”

Section: Infección Urinaria Y Fi Mosisunclassified

Fimosis y Circuncisión

2010

Rev. chil. pediatr.

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Phimosis and CircumcisionThe term phimosis is used when the prepuce cannot be reytracted behind the glans. This condition is oresent in almost all newborns, fulfi lling mostly a protective function. In childhood, a gradual separation occurs, which is completed in adolescence. Through this process, complications may happen such as urinary tract infections, balanitis, or paraphimosis. Circumcision has been considered the treatment of choice, although some factors must be weighed: degree of narrowing, complications, opinión and religious beliefs of the parents. In the past 15 years, publications have suggested topical steroids as an alternative treatment, with variable success. Treatment of phimosis will continue to be controversial. RESUMENEl término fi mosis se utiliza cuando el prepucio no puede ser retraído por detrás del glande. Esta condición está presente en casi todos los recién nacidos cumpliendo una función principalmente protectora. Durante la infancia se produce una separación gradual del prepucio, que se completa, en la mayoría de los casos, al llegar la adolescencia. Mientras ocurre el proceso de desprendimiento pueden presentarse complicaciones como; infección del tracto urinario, balanitis o parafi mosis. La circuncisión ha sido tradicionalmente el tratamiento de elección, sin embargo, se debe tener en cuenta diversos factores antes de tomar una decisión quirúrgica. Debe ser considerado: el grado de estrechez, las complicaciones, la opinión y las creencias religiosas de los padres. En los últimos 15 años se han publicado numerosos trabajos sobre el uso de esteroides tópicos como alternativa terapéutica, con resultados de éxito variable. El tratamiento de la fi mosis seguirá siendo un tema controvertido. (Palabras clave: Fimosis, prepucio, glande, circuncisión). Rev Chil Pediatr 2010; 81 (2): 160-165

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“…Инфекции мочевыводящих путей (ИМВП) -ведущая причина тяжелых бактериальных инфекций у младен-цев; наблюдаются у 7% детей младше 6 мес жизни и у 5% в возрасте от 6 до 24 мес [1]. ИМВП в период детства переносят в среднем до 10% девочек и 3% маль-чиков.…”

Section: Introductionunclassified

Urinary Tract Infection in Children

Маргиева¹,

Komarova²,

Костюшина³

et al. 2014

Pediatr. farmakol.

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путей, этиология, патогенез, клинические проявления, диагностика, лейкоцитурия, бактериурия, сбор мочи, лечение, антибактериальная терапия, профилактика, прогноз, новорожден-ные, младенцы, дети. (Педиатрическая фармакология. 2014; 11 (4): 124-128) Urinary Tract Infection in Children ВВЕДЕНИЕИнфекции мочевыводящих путей (ИМВП) -ведущая причина тяжелых бактериальных инфекций у младен-цев; наблюдаются у 7% детей младше 6 мес жизни и у 5% в возрасте от 6 до 24 мес [1]. ИМВП в период детства переносят в среднем до 10% девочек и 3% маль-чиков. Пузырно-мочеточниковый рефлюкс (ПМР) выяв-ляют после эпизода ИМВП, особенно у новорожденных и младенцев (в 36-49% случаев). В возрасте до 6 мес не наблюдается различий в частоте встречаемости ПМР у мальчиков и девочек [2,3]. ИМВП делят на осложнен-ные, протекающие с лихорадкой (чаще всего пиелонеф-рит), и неосложненные -без лихорадки (чаще инфек-ция нижних мочевыводящих путей). ЭТИОЛОГИЯ И ПАТОГЕНЕЗСреди возбудителей инфекций мочевыводящих путей у детей преобладает грамотрицательная фло-ра, при этом около 90% приходится на инфицирова-ние бактериями Escherichia coli. Грамположительные

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Prevalence of Urinary Tract Infection in Childhood

Cited by 758 publications

References 31 publications

National Ambulatory Antibiotic Prescribing Patterns for Pediatric Urinary Tract Infection, 1998–2007

National Ambulatory Antibiotic Prescribing Patterns for Pediatric Urinary Tract Infection, 1998–2007

Fimosis y Circuncisión

Urinary Tract Infection in Children

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