[Long-term Cefadroxil prophylaxis in children with recurrent urinary tract infections]

Area of Science:

• Pediatric Nephrology
• Infectious Diseases
• Pharmacology

Background:

• Recurrent urinary tract infections (UTIs) are common in children, often requiring long-term management.
• Establishing effective and safe prophylactic strategies is crucial for preventing UTIs and associated complications.
• Cefadroxil is a cephalosporin antibiotic with potential for UTI prophylaxis.

Purpose of the Study:

• To evaluate the efficacy and safety of low-dose, long-term cefadroxil prophylaxis in preventing recurrent UTIs in pediatric patients.
• To compare the effectiveness of daily versus alternate-night cefadroxil administration.
• To assess the impact of cefadroxil prophylaxis on daytime and nighttime wetting.

Main Methods:

• A prospective, randomized trial involving 33 children (aged 2-14 years) with recurrent UTIs.
• Children received six-month prophylaxis with cefadroxil (12.5-15.0 mg/kg) either nightly or on alternate nights.
• Infection recurrence rates, causative agents, and adverse events were monitored.

Main Results:

• Cefadroxil prophylaxis was effective in 80% (daily) and 78% (alternate night) of patients, with no significant difference in reinfection rates between groups (p=0.88).
• The incidence of day- and night-time wetting significantly decreased post-prophylaxis (from 42.4% to 9.1% and 39.4% to 6.1%, respectively).
• Only one patient (3%) experienced mild nausea, indicating good tolerability.

Conclusions:

• Cefadroxil is an effective, well-tolerated, and safe agent for preventing recurrent UTIs in children.
• Alternate-night cefadroxil prophylaxis may offer a cost-effective alternative to daily dosing.
• Cefadroxil prophylaxis significantly improves daytime and nighttime wetting symptoms in children with recurrent UTIs.