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Temocillin in the treatment of pyelonephritis in children
Insights
Temocillin effectively treated Gram-negative pediatric urinary tract infections, showing clinical and bacteriological success. This beta-lactamase-stable penicillin demonstrated safety and efficacy in children with complicated pyelonephritis.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
- Antimicrobial resistance
Background:
- Temocillin is a beta-lactamase-stable penicillin with a selective Gram-negative spectrum and long half-life.
- Previous adult studies confirmed its efficacy and safety for Gram-negative infections.
- Pediatric data on temocillin for complicated urinary tract infections (UTIs) was limited.
Purpose of the Study:
- To evaluate the clinical and bacteriological efficacy and safety of temocillin in children with complicated UTIs.
- To assess temocillin's effectiveness against common Gram-negative pathogens causing pediatric UTIs.
- To determine the safety profile of temocillin in a pediatric population.
Main Methods:
- A prospective study involving 22 children (3 months to 13 years) with complicated UTIs.
- Temocillin administered intravenously at 25 mg/kg every 12 hours for a mean of 5.9 days.
- Clinical and bacteriological outcomes were monitored, along with adverse events and laboratory values.
Main Results:
- Clinical improvement occurred within 24-36 hours in all patients with temocillin-sensitive organisms.
- Bacteriological cure was achieved in all patients with temocillin-sensitive pathogens.
- No adverse reactions or abnormal laboratory values were observed during treatment.
Conclusions:
- Temocillin demonstrated significant clinical and bacteriological efficacy in treating pediatric complicated UTIs, particularly pyelonephritis.
- The drug was well-tolerated, with no adverse effects or laboratory abnormalities noted in the study cohort.
- Temocillin is a safe and effective option for pediatric pyelonephritis, especially when caused by ampicillin-resistant Gram-negative bacteria.
Abstract:
Temocillin is a beta-lactamase-stable penicillin with a selective. Gram-negative spectrum of activity and a long half-life. Previous studies in adult patients have demonstrated its efficacy and safety in the treatment of Gram-negative infections. The aim of the study was to evaluate the clinical and bacteriological efficacy and safety of temocillin in children with complicated urinary tract infections. Twenty-two children, aged 3 months to 13 years (mean 5.8 years) were treated with temocillin i.v. at a dose of 25 mg/kg 12 hourly for a mean period of 5.9 days (range 3-12 days). Acute pyelonephritis was diagnosed in 21 patients (one case associated with septicaemia); one patient presented recurrent bacteriuria due to a multiresistant pathogen. Some 20/22 children presented an underlying condition complicating the urinary tract infection (UTl). The causative pathogens, isolated from the urine, were: E. coli (17), Proteus mirabilis (3), Enterobacter cloacae (1), enterococcus (1). The enterococcus and one Proteus mirabilis were found to be resistant to temocillin. Clinical improvement was obtained after 24-36 h in all children with temocillin-sensitive organisms. Bacteriological cure was obtained in all patients with temocillin-sensitive organisms. The two patients with temocillin-resistant pathogens were treated with another antibiotic. Follow-up treatment was given per os during +/- 2 weeks. No adverse reactions or abnormal laboratory values were noted. In the authors' limited experience temocillin proved to be effective and safe in the treatment of pyelonephritis often due to ampicillin-resistant strains in children.