Examine the usage of short-course antibiotic therapy to treat pediatric urinary tract infection
|
Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on January 15th, 2024
|
Amid the escalating concern surrounding antimicrobial resistance, discussions have emerged regarding the utilization of short-course antibiotic regimens as opposed to longer ones, aiming to reduce undue selective pressure for resistant phenotypes. A recent study evaluating the effectiveness of short-course therapy for pediatric urinary tract infections has released its findings in the Journal of the American Medical Association.
The randomized clinical trial involved 664 children aged between 2 months and 10 years diagnosed with urinary tract infection. These participants were randomly allocated to be treated with either the standard 10-day antibiotic therapy or a shorter 5-day course. More than half of the patients were treated with cefdinir, and about one third was treated with cephalexin. The combination of trimethoprim and sulfamethoxazole was used in 10% of the children; amoxicillin-clavulanate and cefixime was used but at a lesser rate. Among those treated with the shorter regimen, 4.2% experienced persistent urinary tract infection post-treatment, a notably higher figure compared to the 0.6% rate observed in children who underwent the 10-day antibiotic course. Moreover, there was a significantly higher incidence of asymptomatic bacteriuria among children who received the shorter therapy. Despite the higher rate of treatment failure, the study concluded that it is not too severe and can potentially be a beneficial trade-off to reduce the rate of antimicrobial resistance in children who might have responded to the early period of treatment.
The randomized clinical trial involved 664 children aged between 2 months and 10 years diagnosed with urinary tract infection. These participants were randomly allocated to be treated with either the standard 10-day antibiotic therapy or a shorter 5-day course. More than half of the patients were treated with cefdinir, and about one third was treated with cephalexin. The combination of trimethoprim and sulfamethoxazole was used in 10% of the children; amoxicillin-clavulanate and cefixime was used but at a lesser rate. Among those treated with the shorter regimen, 4.2% experienced persistent urinary tract infection post-treatment, a notably higher figure compared to the 0.6% rate observed in children who underwent the 10-day antibiotic course. Moreover, there was a significantly higher incidence of asymptomatic bacteriuria among children who received the shorter therapy. Despite the higher rate of treatment failure, the study concluded that it is not too severe and can potentially be a beneficial trade-off to reduce the rate of antimicrobial resistance in children who might have responded to the early period of treatment.