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Prophylactic cefdinir for pediatric cases of complicated urinary tract infection
Tomohiro Oishi1, Kazuyuki Ueno, Kyoko Fukumoto
1Department of Pediatrics, Niigata Prefectural Shibata Hospital, Shibata-shi, Nigata, Japan. oo0612@hotmail.com
Insights
Cefdinir, an antibiotic, effectively prevented recurrent urinary tract infections (UTIs) in infants. The medication was safe and well-tolerated, showing a 93% recurrence-free rate over six months.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology and Therapeutics
Background:
- Recurrent and complicated urinary tract infections (UTIs) pose a significant challenge in pediatric care.
- Prophylactic antibiotic use is a strategy to prevent UTI recurrence, but requires careful evaluation for efficacy and safety.
Purpose of the Study:
- To evaluate the efficacy and safety of prophylactic cefdinir (3 mg/kg once daily) for preventing recurrent and complicated UTIs in infants.
- To assess the pharmacokinetic profile of cefdinir in pediatric patients with UTIs.
Main Methods:
- A study involving 14 infants (8 boys, 6 girls) with a mean age of 6.2 months.
- Patients had underlying conditions such as vesico-ureteric reflux or ureteropelvic junction stenosis.
- Observation period of at least 6 months post-infection, with regular monitoring of urinary cefdinir concentrations and fecal cultures.
Main Results:
- A 6-month recurrence-free rate of 93% (13/14) was achieved, with only one patient experiencing recurrent UTI.
- No adverse drug reactions, including diarrhea, led to discontinuation of cefdinir.
- Urinary cefdinir concentrations, though variable, were sufficient to eradicate Escherichia coli, a common UTI pathogen. E. coli strains remained sensitive to cefdinir.
Conclusions:
- Prophylactic cefdinir at 3 mg/kg once daily is a highly effective and safe option for preventing recurrent complicated UTIs in infants.
- The findings support the use of cefdinir in managing pediatric UTIs, particularly in high-risk populations.
Background:
This study evaluated the effect of prophylactic cefdinir (3 mg/kg given once daily) for the prevention of recurrent and complicated urinary tract infections (UTI) in pediatric patients.
Methods:
The study included 14 infants who were observed for at least 6 months following the first signs of infection (eight boys, six girls; mean age at admission [± SD]: 6.2 [± 7.4] months). Twelve patients had vesico-ureteric reflux (grade I, two; grade II, three; grade III, six; grade IV, one), and two patients had ureteropelvic junction stenosis.
Results:
No patients discontinued medication due to diarrhea or other adverse drug reactions. The patients had a 6-month recurrence-free rate of 93% (13/14); only one patient had recurrent UTI. The mean urinary cefdinir concentration was 16.3 [± 11.7]µg/mL; there was considerable variability among individual measurements, even though the samples were collected at similar intervals after drug intake (mean 18.00 [± 2.63] h after dose). However, the lowest measured urinary cefdinir concentration (1.16 µg/mL) was sufficient to eradicate Escherichia coli, one of the most significant causes of UTI. Fecal cultures, obtained at monthly clinic visits during the observation period, indicated that the patients' E. coli strains were very sensitive to cefdinir. No patients were infected with Pseudomonas aeruginosa or other non-fermenting Gram-negative bacilli or fungi.
Conclusions:
These results show that cefdinir given 3 mg/kg once daily is very effective and safe for preventing recurrent complicated UTI in infants.
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