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Rational Therapy of Urinary Tract Infections in Children in Croatia
Danko Milošević1,2, Danica Batinić3, Vladimir Trkulja1,2
1Zagreb University Hospital Center, University of Zagreb School of Medicine, Zagreb, Croatia
Insights
Antimicrobial resistance is rising globally, necessitating careful antibiotic selection for urinary tract infections (UTIs). Optimal treatment balances efficacy, patient safety, and cost-effectiveness, especially in children.
Area of Science:
- Infectious Diseases
- Pharmacology
- Pediatrics
Background:
- Increasing global resistance to chemotherapeutics for urinary tract infections (UTIs) poses a significant clinical challenge.
- Bacterial resistance patterns in Croatia and neighboring regions highlight the need for optimized antibiotic selection.
- Pediatric UTIs require special consideration due to age-related risks of systemic reactions and renal scarring.
Purpose of the Study:
- To emphasize the critical need for optimal antibiotic selection in managing urinary tract infections.
- To highlight the importance of considering local resistance patterns and clinical experience.
- To underscore the financial considerations and cost-benefit analysis in antimicrobial therapy.
Main Methods:
- Review of clinical experiences and current bacterial resistance data.
- Analysis of treatment strategies for pediatric urinary tract infections.
- Evaluation of financial aspects and cost-effectiveness in antimicrobial therapy.
Main Results:
- Optimal antibiotic selection is crucial given rising antimicrobial resistance.
- Early switch from parenteral to oral antibiotics is recommended when feasible.
- Financial considerations must align with the principle of 'primum non nocere' (first, do no harm).
Conclusions:
- Judicious antibiotic selection is paramount for effective UTI treatment amidst growing resistance.
- Pediatric UTI management requires a tailored approach prioritizing safety and minimizing long-term complications.
- Antimicrobial therapy decisions must integrate clinical efficacy, safety, local resistance data, and economic factors.
Abstract:
Resistance to chemotherapeutics used in the treatment of urinary tract infection is increasing throughout the world. Taking into account clinical experiences, as well as current bacterial resistance in Croatia and neighboring countries, the selection of antibiotic should be the optimal one. Treatment of urinary tract infection in children is particularly demanding due to their age and inclination to severe systemic reaction and renal scarring. If parenteral antibiotics are administered initially, it should be switched to oral medication as soon as possible. Financial aspects of antimicrobial therapy are also very important with the main goal to seek the optimal cost/benefit ratio. Financial orientation must appreciate the basic primum non nocere as a conditio sine qua non postulate as well.