Outcome of Antimicrobial Therapy of Pediatric Urinary Tract Infections Caused by Extended-Spectrum beta-Lactamase-Producing Enterobacteriaceae / 감염과화학요법
Infection and Chemotherapy
;
: 415-421, 2013.
Artigo
em Inglês
| WPRIM
| ID: wpr-62688
ABSTRACT
BACKGROUND:
The purpose of this study was to compare the outcome of carbapenem versus non-carbapenem antimicrobial therapy for pediatric urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. MATERIALS ANDMETHODS:
From 2006 to 2011, 42 episodes of UTI caused by ESBL-producing Enterobacteriaceae were diagnosed at Seoul National University Children's Hospital. Patients were grouped according to the antimicrobials they received into a carbapenem group and a non-carbapenem group. Medical records were retrospectively reviewed to assess treatment outcome, time to defervescence after initiation of treatment, and relapse rate.RESULTS:
There were 36 children with 42 episodes of UTI caused by ESBL-producing Enterobacteriaceae. Twenty-seven cases (64%) had an underlying urologic disease, 28 (67%) cases were caused by Escherichia coli, and 14 (33%) cases were caused by Klebsiella pneumoniae. Four (10%) cases were treated with carbapenem, 23 cases (55%) were treated with non-carbapenem, and 15 (36%) cases were treated by switching from a carbapenem to a non-carbapenem and vice versa. There was no treatment failure at the time of antimicrobial discontinuation. Between the carbapenem and the non-carbapenem treatment groups, there were no significant differences in bacterial etiology (P = 0.59), time to defervescence after the initiation of antimicrobials (P = 0.28), and relapse rate (P = 0.50). In vitro susceptibility to non-carbapenem antimicrobials did not affect the time to defervescence after the initiation of antimicrobial treatment, and the relapse rate in the non-carbapenem group.CONCLUSIONS:
This study found no significant difference in the treatment outcome between pediatric patients treated with carbapenem and those treated with non-carbapenem antimicrobials for UTI caused by ESBL-producing Enterobacteriaceae. Therefore, the initially administered non-carbapenem can be maintained in UTI patients showing clinical improvement.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Recidiva
/
Sistema Urinário
/
Infecções Urinárias
/
Doenças Urológicas
/
Beta-Lactamases
/
Prontuários Médicos
/
Estudos Retrospectivos
/
Resultado do Tratamento
/
Falha de Tratamento
/
Enterobacteriaceae
Tipo de estudo:
Estudo observacional
Limite:
Criança
/
Humanos
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Infection and Chemotherapy
Ano de publicação:
2013
Tipo de documento:
Artigo
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