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Efficacy of Empiric Treatment of Urinary Tract Infections in Neonates and Young Infants
James W Antoon1, Paige J Reilly1, Erin H Munns2
1University of Illinois at Chicago College of Medicine, IL, USA.
Insights
Current antibiotic treatments are effective for most young infants with urinary tract infections (UTIs). However, rising resistance, particularly with enterococcal infections, necessitates ongoing monitoring in this vulnerable population.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Antibiotic resistance patterns in young infants with UTIs have changed significantly over 20 years.
- The efficacy of current empiric antibiotic therapy for infant UTIs remains unclear.
Purpose of the Study:
- To evaluate the effectiveness of current empiric antibiotic regimens for UTIs in infants aged 0–60 days.
- To identify factors associated with antibiotic resistance and prolonged hospital stays in this demographic.
Main Methods:
- Retrospective chart review of infants (0–60 days) diagnosed with UTIs.
- Analysis of antibiotic susceptibility data and clinical outcomes.
- Evaluation of ultrasound's utility in detecting genitourinary anomalies.
Main Results:
- Overall susceptibility to empiric antibiotics was 87%.
- Higher resistance and longer hospital stays were observed in afebrile infants, ICU admissions, and those with enterococcal UTIs.
- Ultrasound showed 70% sensitivity and 40% specificity for genitourinary anomalies.
Conclusions:
- Empiric antibiotics effectively treat a majority of infant UTIs.
- Enterococcal infections are linked to significant resistance and prolonged hospital stays, requiring vigilant surveillance.
- Continued monitoring of antibiotic resistance in infant UTIs is crucial.
Abstract:
Background. The antibiotic resistance patterns of young infants with urinary tract infections (UTIs) have evolved over the past 2 decades. Whether current empiric antibiotic regimens are sufficient in this age group is unknown. Methods. A retrospective review of patients aged 0 to 60 days admitted with a UTI discharge diagnosis. Results. Overall susceptibility to empiric antibiotics was 87%. Antibiotic resistance and length of stay were highest among those who were afebrile, those admitted to the intensive care unit, and those with culture diagnosis of enterococcal infection. The sensitivity and specificity of ultrasound as a screening tool for genitourinary anomaly was 70% and 40%, respectively, with a positive predictive value of 31.8%. Conclusions. Empiric antibiotic regimens cover a high percentage of UTIs in infants. However, high rates of resistance and prolonged length of stay in patients with enterococcal infection highlight the need for continued surveillance of such patients in this age group.
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