Cefaclor has been investigated as an additional prophylactic agent in the UTI. It is active against virtually all common urinary pathogens, is well absorbed in the upper gastrointestinal tract, is well tolerated and safe. The Authors have carried out a clinical trial of the prophylactic use of
cefaclor in the prevention of recurrent
urinary tract infection in children. We studied 52 children (25 females and 27 males, median age 7 +/- 19 months) with UTI, investigated by imaging (sonography, micturating cystourethrography, renal scintigraphy) and by urodynamic studies. We found
vesicoureteral reflux in 37 cases, primitive megaureter in 6 cases, in 1 patient duplication of the collecting system in 1 patient and substenosis of ureteropelvic junction in 1 case. In the others 5 cases the UTI were associated with bladder disfunction and finally in 1 case the UTI occurred in absence of urinary malformations. All patients received
cefaclor, as prophylaxis, at the dosage of 10-20 mg/kg/die, administrated as a single bedtime dose. The mean time of treatment with
cefaclor was 8 +/- 3,48 months. We observed an optimal compliance in all patients, also in the first year of life. In only two out of 52 patients, during the prophylaxis, we found documented
bacteriuria. We stopped treatment in two cases because of an adverse effect (in both children has been demonstrated a cutaneous
rash). In conclusion our study shows that
cefaclor is an effective, well tolerated and safe agent in the UTI prophylaxis, also in the first year of life, when it seems to offer an optime alternative to other agents.