Related Experiment Videos
First generation cephalosporins as therapy for uncomplicated pyelonephritis in children. A retrospective analysis
1Department of Pediatrics, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Insights
First-generation cephalosporins can effectively treat pyelonephritis in otherwise healthy children. Therapeutic success is achievable even with some bacterial resistance, supporting their use in specific pediatric cases.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
Background:
- Optimal management of pediatric pyelonephritis lacks consensus.
- First-generation cephalosporins are a potential treatment option.
Purpose of the Study:
- To evaluate the efficacy of first-generation cephalosporins in treating pediatric pyelonephritis.
- To compare outcomes between first-generation cephalosporins and broad-spectrum antibiotics.
Main Methods:
- Retrospective analysis of 129 pediatric patients with pyelonephritis.
- Patients were divided into two groups: first-generation cephalosporins (n=97) and broad-spectrum antibiotics (n=32).
- Clinical data and pathogen resistance patterns were analyzed.
Main Results:
- Patients receiving first-generation cephalosporins had fewer prior urinary infections or abnormalities (16.2% vs. 53.1%).
- Pathogens other than E. coli were less common in the first-generation cephalosporin group (7.3% vs. 25%).
- Despite 22.6% pathogen resistance, only 7.5% required treatment change.
Conclusions:
- First-generation cephalosporins are a viable treatment for pyelonephritis in otherwise healthy children in this region.
- Therapeutic success can be achieved despite observed bacterial resistance.
- This supports the use of first-generation cephalosporins in selected pediatric pyelonephritis cases.
Abstract:
There is no consensus opinion for the optimal management of pyelonephritis in children. We summarized our experience with first generation cephalosporins by a retrospective analysis of 129 pediatric patients with pyelonephritis who were treated either by first generation cephalosporins (97 patients, group 1) or broad-spectrum antibiotics (32 patients, group 2). Group 1 patients were less likely to have reported previous urinary infections or anatomical urinary tract abnormalities (16.2% vs. 53.1%, p= 0.002) and pathogens other than E. coli (7.3% vs. 25%, p=0.02). Resistance to first generation cephalosporins was identified in 22.6% of pathogens cultured, however, only 7.5% of them had poor clinical responses and required alternative treatment replacement. Our findings show that first generation cephalosporins could be used in our region to treat pyelonephritis in an otherwise healthy child, and that they can provide therapeutic success even in the face of apparent bacterial resistance.