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First and recurrent pediatric urinary tract infections: do they have different antibiotic susceptibilities?

H Narchi1, M Al-Hamdani

  • 1Department of Pediatrics, Faculty of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. hassib.narchi@uaeu.ac.ae <hassib.narchi@uaeu.ac.ae>

Journal of Chemotherapy (Florence, Italy)
|August 5, 2008
PubMed

Insights

Antibiotic resistance in children

Area of Science:

  • Pediatric infectious diseases
  • Antimicrobial resistance
  • Urology

Background:

  • Antibiotic susceptibility studies in children often do not distinguish between initial and repeat urinary tract infections (UTIs).
  • Recurrent UTIs in children may be linked to urinary tract anomalies and antibiotic prophylaxis, potentially increasing uropathogen antibiotic resistance.
  • Understanding resistance patterns in first versus recurrent UTIs is crucial for effective treatment.

Purpose of the Study:

  • To investigate differences in antibiotic resistance patterns between first and recurrent urinary tract infections (UTIs) in pediatric patients.
  • To determine if specific antibiotics show varying resistance rates in initial versus subsequent UTIs.

Main Methods:

  • Retrospective analysis of 250 culture-proven urinary tract infection (UTI) episodes in 154 children (2 months to 12 years).
  • Data collected on first-time UTIs (145 episodes) and recurrent UTIs (105 episodes).
  • Univariate and multivariable analyses were performed to compare antibiotic resistance between the two groups, adjusting for confounding factors.

Main Results:

  • Univariate analysis indicated significantly lower resistance to cefuroxime and gentamicin in recurrent UTIs compared to first UTIs.
  • Multivariable analysis confirmed this association, with adjusted odds ratios of 0.8 for cefuroxime (p=0.04) and gentamicin (p=0.003).
  • Resistance rates for other antibiotics did not significantly differ between first and recurrent UTIs.

Conclusions:

  • Recurrent urinary tract infections (UTIs) in children are not associated with higher resistance to cefuroxime and gentamicin.
  • The findings suggest that antibiotic resistance patterns may differ based on UTI history in pediatric populations.
  • Further research is needed to explore the implications for antibiotic stewardship in pediatric UTIs.

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