title: Validation of Cefazolin as Initial Antibiotic for First Upper Urinary Tract Infection in Children.
abstract: To validate the policy of administering cefazolin (CEZ) as a first-line antibiotic to children who are hospitalized with their first febrile urinary tract infection (UTI), we evaluated microbial susceptibility to CEZ and the efficacy of CEZ. The 75 enrolled children with febrile UTI were initially treated with CEZ. Switching CEZ was not required in 84% of the patients. The median fever duration, prevalence of bacteremia, prevalence of UTI caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, and median duration of hospitalization were significantly higher in the CEZ-ineffective group. The risks of vesicoureteral reflux, indication of operation, and renal scarring are not increased, even when CEZ is ineffective as a first-line antibiotic. CEZ is effective in more than 80% of pediatric patients with their first febrile UTI, but it should be switched to appropriate antibiotics considering sepsis or the ESBL-producing Enterobacteriaceae pathogen, when fever does not improve within 72 hours.
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Wakabayashi
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Yasuha
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Machida
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Endo
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Tamai
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sakurai
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hibino
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mikawa
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Ugajin
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Fukuchi
authors.affiliation: Showa University, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Itabashi
keywords: antibiotics; cefazolin; children; upper urinary tract infection; validation