Ampicillin-sulbactam monotherapy in infants with febrile urinary tract infections.

Abstract

BACKGROUND:

Cephalosporin is the most commonly used empirical agent for urinary tract infections (UTIs) in children. However, increasing use of cephalosporins can lead to an increase in resistant pathogens. This study therefore aims to investigate the effects of monotherapy with ampicillin-sulbactam as an alternative to cephalosporins.

METHODS:

All 2- to 24-month-old patients who were hospitalized at Pusan National University Children's Hospital due to a first episode of a febrile UTI during the 2-year period from 2012 to 2014 were included in the study. The subjects were divided into two groups according to their empirical therapy (cefotaxime or ampicillin-sulbactam). We determined the patients' UTI pathogens and their antibiotic susceptibilities and compared the effectiveness and the occurrence of adverse effects of ampicillin-sulbactam and cephalosporin therapy.

RESULTS:

Forty-six patients were treated with cefotaxime (group A) and 41 patients with ampicillin-sulbactam as the empirical antibiotic (group B). The most common pathogen in both groups was Escherichia coli, and antibiotic susceptibilities of the bacterial strains isolated from both groups were similar in ampicillin-sulbactam and cefotaxime. In addition, there was no significant difference in the duration of fever after treatment between the two groups (group A: 2.0 versus group B: 3.0, P = 0.331). There were no treatment failures and no recurrence in either group, even in patients with resistant pathogens. The most common side effect of the antibiotic agents was diarrhea.

CONCLUSIONS:

Ampicillin-sulbactam could be an effective alternative to cephalosporin as empiric antibiotic for the treatment of first-episode UTI in patients under 24 months of age.

• Authors: Ji Yeon Song, Sukdong Yoo, Taek Jin Lim, Joung-Hee Byun, Kyo Jin Jo, Hye-Young Kim, Su Eun Park, Seong Heon Kim
• Journal: Pediatrics international : official journal of the Japan Pediatric Society (Pediatr Int) Vol. 63 Issue 4 Pg. 430-435 (Apr 2021) ISSN: 1442-200X [Electronic] Australia
• PMID: 32885532 (Publication Type: Journal Article)
• Copyright: © 2020 Japan Pediatric Society.

Chemical References

• Anti-Bacterial Agents
• sultamicillin
• Ampicillin
• Sulbactam

Topics

• Ampicillin (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Bacterial Infections (drug therapy)
• Child
• Child, Preschool
• Drug Therapy, Combination
• Humans
• Infant
• Sulbactam (therapeutic use)
• Urinary Tract Infections (drug therapy)