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Article Dans Une Revue (Article De Synthèse) Infectious Diseases Now Année : 2023

Antimicrobial treatment of urinary tract infections in children.

Résumé

Urinary tract infections are the most frequently proven bacterial infections in pediatrics. The treatment options proposed in this guide are based on recommendations published by the Groupe de Pathologie Infectieuse de Pédiatrique (GPIP-SFP). Except in rare situations (newborns, neutropenia, sepsis), a positive urine dipstick for leukocytes and/or nitrites should precede a urine culture examination and any antibiotic therapy. After rising steadily between 2000 and 2012, the proportion of Escherichia coli strains resistant to extended-spectrum ß-lactamases (E-ESBL) has remained stable over the last ten years (between 7% and 10% in pediatrics). However, in many cases no oral antibiotic is active on E-ESBL leading either to prolonged parenteral treatment, or to use of a non-orthodox combination such as cefixime + clavulanate. With the aim of avoiding penem antibiotics and encouraging outpatient management, this guide favors initial treatment of febrile urinary tract infections (suspected or actual E-ESBL infection), with amikacin. Amikacin remains active against the majority of E-ESBL strains. It could be prescribed as monotherapy for patients in pediatric emergency departments or otherwise hospitalized patients.

Dates et versions

hal-04549839 , version 1 (17-04-2024)

Identifiants

Citer

Fouad Madhi, Alexis Rybak, Romain Basmaci, Anne-Sophie Romain, Andréas Werner, et al.. Antimicrobial treatment of urinary tract infections in children.. Infectious Diseases Now, 2023, Infectious Diseases Now, pp.104786. ⟨10.1016/j.idnow.2023.104786⟩. ⟨hal-04549839⟩
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