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[Treatment of initial urinary tract infection in children with cotrifamole and cotrimoxazole. A double-blind study]
Insights
This study found cotrimoxazole and cotrifamole equally effective for treating initial childhood urinary tract infections (UTIs). Researchers recommend a lower dose of cotrifamole for future UTI treatment.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Urology
Background:
- Urinary tract infections (UTIs) are common in children.
- Effective antibiotic treatment is crucial to prevent complications.
- Comparing different antibiotic regimens is essential for optimal patient care.
Purpose of the Study:
- To compare the efficacy and safety of cotrimoxazole and cotrifamole in treating initial episodes of pediatric urinary tract infections.
- To evaluate clinical outcomes, laboratory values, and radiological findings in children receiving either antibiotic.
- To determine the long-term recurrence rates of UTIs after treatment with the studied regimens.
Main Methods:
- A prospective, randomized, double-blind trial involving 28 children with initial UTIs.
- Treatment administered for 14 days with either cotrimoxazole or cotrifamole (trimethoprim/sulfamethoxazole) in a 3:2 ratio.
- Assessment included clinical signs, cure rates, laboratory parameters (hemoglobin, WBC, liver/renal function), and kidney/urinary tract X-ray abnormalities.
- Follow-up for up to 12 months to monitor reinfections and relapses.
Main Results:
- No significant differences were observed in clinical signs, efficacy, or cure rates between the cotrimoxazole and cotrifamole groups.
- Laboratory studies revealed no adverse effects or significant changes in hemoglobin, WBC, liver, or renal function in either treatment group.
- Radiological assessments showed similar rates of abnormalities in the kidneys and urinary tract for both groups.
- The incidence of reinfections and relapses within 12 months post-treatment was comparable between the two antibiotic regimens.
Conclusions:
- Both cotrimoxazole and cotrifamole demonstrate similar efficacy and safety profiles for treating initial pediatric urinary tract infections.
- The study supports the use of cotrifamole, suggesting a potentially lower effective dose (2:3 ratio) compared to cotrimoxazole.
- Further research may explore optimized dosing strategies for cotrifamole in pediatric UTI management.
Abstract:
28 children with initial episodes of urinary tract infection were treated with cotrimoxazole or cotrifamole (dose ratio 3 : 2) for 14 days in a prospective randomized double blind trial. The two groups did not differ as regards clinical signs. The efficacy and cure rates of each regimen were similar. Laboratory studies (hemoglobin, WBC, liver, and renal function) showed no differences between both groups before and after therapy; an alteration of the laboratory values could not be observed during therapy. The number of children with X-ray abnormalities of kidneys and urinary tract was similar in both groups. During an observation time of up to 12 months after the first urinary tract infection no differences in the number of reinfections and relapses were observed. As a result of this study, we recommend cotrifamole in a lower dose (ratio 2 : 3) than cotrimoxazole for the treatment of urinary tract infection.