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Urinary Tract Infection in Children and the Potential Role of Pivmecillinam as a Treatment Option

Naja Lyhne Andersen1,2, Valeria Antsupova3, Jonas Bredtoft Boel3

  • 1From the Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital Herlev-Gentofte, Copenhagen, Denmark.

The Pediatric Infectious Disease Journal
|December 20, 2024
PubMed

Insights

Pivmecillinam shows promise for treating pediatric urinary tract infections, with 83% of children responding well. However, resistance in infants highlights the need for a pediatric oral formulation of pivmecillinam.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacology
  • Microbiology

Background:

  • Urinary tract infections (UTIs) are common in children, requiring effective and safe antimicrobial treatments.
  • Pivmecillinam is a penicillin antibiotic with established efficacy in adults for UTIs, but its pediatric use is less explored.

Purpose of the Study:

  • To evaluate the efficacy of pivmecillinam in treating urinary tract infections in children aged 0-6 years.
  • To identify bacterial resistance patterns to pivmecillinam in pediatric UTI cases.

Main Methods:

  • A study involving 351 children (0-6 years) diagnosed with urinary tract infections.
  • Treatment efficacy assessed after urine culture and susceptibility testing.
  • Analysis of resistance patterns, particularly in infants (0-3 months).

Main Results:

  • Pivmecillinam successfully treated 83% of the pediatric urinary tract infection cases.
  • The highest rates of resistance were observed in infants (0-3 months).
  • Enterococcus faecalis was identified as a significant contributor to resistance in this age group.

Conclusions:

  • Pivmecillinam demonstrates considerable potential as a treatment option for urinary tract infections in children.
  • The high prevalence of Enterococcus faecalis resistance in infants necessitates further investigation and tailored treatment strategies.
  • There is a clear need for the development of an oral pediatric formulation of pivmecillinam to improve treatment accessibility and adherence.

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