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[Cefazolin efficacy and antibiotic sensitivity against pathogenic bacteria in pediatric with acute upper urinary
Toshiya Fuke1, Yoshifusa Abe, Akihiro Hoshino
1Department of Pharmacy Services, Showa University Hospital.
Insights
Cefazolin (CEZ) is an effective first-line treatment for acute upper urinary tract infections in children. This study shows high efficacy and negative urine cultures, supporting its use against common pathogens like E. coli.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
- Antimicrobial resistance
Context:
- Acute upper urinary tract infections (UTIs) pose a significant risk of sepsis, particularly in neonates and infants.
- The rise in bacterial resistance necessitates careful selection of effective antibacterials.
- Clinical practice varies in antibacterial therapy choices due to institutional protocols and disease severity.
Purpose:
- To evaluate the efficacy of cefazolin (CEZ), a first-generation cephalosporin, as a first-line parenteral treatment for acute upper UTIs.
- To compare the effectiveness of CEZ against other common antibacterial agents, including ceftazidime (CAZ), ampicillin, and gentamicin, specifically against Escherichia coli.
Summary:
- 88.9% of microbial infections indicated CEZ use.
- CEZ demonstrated 91.3% efficacy with 97.2% of urine cultures becoming negative post-treatment.
- Against Escherichia coli, CEZ showed high sensitivity (90.9% with MIC < 4), comparable to ceftazidime (93.9% with MIC < 1) and superior to ampicillin and gentamicin.
Impact:
- Cefazolin is a highly effective and recommended antibacterial agent for initial parenteral therapy in pediatric acute upper UTIs.
- Findings support the use of CEZ in combating common uropathogens and minimizing the development of antimicrobial resistance.
- This study provides evidence for standardized treatment protocols utilizing cefazolin in pediatric UTI management.
Abstract:
Acute upper urinary tract infection may cause sepsis, especially in neonates and infants, mandating the choice of appropriate, effective antibacterials minimizing increasing bacterial resistance. Frequently prescribing broad-spectrum cephalosporinin is one such example. Different antibacterial therapies are initiated clinically due to treatment protocol differences among institutions, disease severity, etc. We studied the efficacy of cefazolin (CEZ), a first-generation cephalosporin, as first-line parenteral treatment in acute upper urinary tract infection. We found that 88.9% of microbial infections have indications for CEZ. CEZ efficacy is 91.3%, and 97.2% of urine cultures show negative results. Escherichia coli sensitivity to antibacterial agents is 90.9% of the minimal inhibitory concentration (MIC) < 4 for CEZ, 93.9% of MIC < 1 for ceftazidime (CAZ), 63.6% of MIC < 4 for ampicillin, and 81.8% of MIC < 2 for gentamicin. CEZ thus has the same efficacy as CAZ and is more effective than other antibacterial agents against E. coli. We concluded that CEZ is an effective antibacterial in initial antibacterial pediatric therapy in acute upper urinary tract infection.
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