[New, successful treatment of urinary tract infection caused by Pseudomonas aeruginosa].
Urinary tract infection (UTI) is common in pediatric practice and an important cause of morbidity and mortality in children. Escherichia coli remains the predominant uropathogen (80%) isolated in acute community-acquired uncomplicated infections, followed by Staphylococcus saprophyticus (10% to 15%) and Pseudomonas aeruginosa (9%) The pathogens traditionally associated with UTI are changing many of their features, particularly because of antimicrobial resistance. Reinfections and relapses of urinary tract infections caused by PA are very frequent. The aim of the study was to evaluate the efficacy of combined clarithromycine and ceftazidime in terms of eradication of PA infection. We analyzed 20 out of 264 children with UTI where PA infection was confirmed with urine culture. Those children were treated for at least 14 days with the protocol used for PA infection in patients with mucoviscidosis. Short-term eradication was achieved in all patients. Long-term study revealed relapse in 25% of children, all with serious congenital malformations. 75% of children were treated with success. No side effects were observed. Conclusion. We conclude that an empirical combination treatment of clarithromycine and ceftazidime is appropriate and effective in children with UTI caused by PA. This therapy was clinically efficacious, well tolerated, and cost effective, and should prevent unnecessary development of antimicrobial resistance.
Sobczyk
Dariusz
D
Klinika Kardiologii i Nefrologii Dzieciecej, Akademii Medycznej w Poznaniu. darso@onet.pl
Krynicki
Tomasz
T
Blumczyński
Andrzej
A
Zaniew
Marcin
M
Kroll
Paweł
P
Siwińska
Aldona
A
Zachwieja
Jacek
J
D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D002442:Ceftazidime / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*
D000892:Anti-Infective Agents, Urinary; D002442:Ceftazidime