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[Treatment of urinary infections in children. Pharmaco-economic aspects]
1Département Universitaire de Pédiatrie, Centre Hospitalier Régional de la Citadelle, Liège.
Insights
Urinary tract infections in children are influenced by age, symptoms, and urinary tract issues. Rising antibiotic resistance necessitates tailored treatments, considering local bacterial sensitivities and cost-effective outpatient management strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Context:
- Urinary tract infections (UTIs) are common in children.
- Key risk factors include young age, severe febrile symptoms, urinary tract abnormalities, recurrent infections, and delayed treatment.
- Increasing antibiotic resistance presents a new challenge in managing pediatric UTIs.
Purpose:
- To highlight evolving risk factors for pediatric UTIs.
- To emphasize the need for treatment strategies adapted to local antibiotic resistance patterns.
- To explore cost-effective management approaches, including reduced inpatient stays and transition to oral antibiotics.
Summary:
- Identified risk factors for pediatric UTIs: young age, severe fever, urinary tract obstruction/dilatation, recurrent infections, and delayed treatment.
- Growing antibiotic resistance is a significant new risk factor.
- Treatment must align with local bacterial sensitivities, favoring reduced inpatient care and early switch to oral antibiotics when appropriate.
Impact:
- Informed clinical practice for pediatric UTI management.
- Promotes cost-effective healthcare strategies.
- Addresses the critical issue of antimicrobial resistance in pediatric populations.
Abstract:
The risk factors for urinary tract infections in children are the young age, the severe febrile symptoms, any obstruction or dilatation of the urinary tract, recurrent episodes of acute disease and delay in initiating effective treatment. Today a new risk factor lies in the increasing resistance of germs to usually used antibiotics. The treatment therefore must be adapted to the local patterns of bacterial sensitives. To lower cost of the therapy, different ways may be followed: 1. To try to reduce the time of the inpatient management by using day-care or outpatient management possibilities. 2. To try to switch from the initial, heavy parenteral drugs to antibiotics to which the germ is sensitive and even to an adapted oral medication, when the child is doing well, is well hydrated and can tolerate the treatment. The outpatient management requires more compliance from the child and may be a burden for the parents.