Clinical Outcome of Discordant Empirical Therapy and Risk Factors Associated to Treatment Failure in Children Hospitalized for Urinary Tract Infections

Dados Bibliográficos

ID15719764
AutoresGiovanni Autore (0000-0002-5895-8313, University of Parma), Cosimo Neglia (0000-0002-9863-7178, University of Parma), Margherita Di Costanzo (0000-0002-8985-770X, Guglielmo da Saliceto Hospital), Martina Ceccoli (0000-0003-1562-8821, University of Modena and Reggio Emilia), Gianluca Vergine (0000-0001-5692-4251, Ospedale Infermi di Rimini), Claudio La Scola (0000-0002-2644-7447, Azienda USL di Bologna), Cristina Malaventura (0000-0001-8517-4170, University of Ferrara), Alice Falcioni (Paediatric Unit, Forlì Hospital, AUSL Romagna, 47121 Forlì, Italy), Alessandra Iacono (0000-0001-5766-608X, Azienda Unità Sanitaria Locale Della Romagna), Antonella Crisafi (0000-0001-5515-3600, Santa Maria Nuova Hospital), Lorenzo Iughetti (0000-0003-0370-7872, University of Modena and Reggio Emilia), Maria Luisa Conte (Ospedale Infermi di Rimini), Luca Pierantoni (0000-0001-8175-5488, Azienda USL di Bologna), Claudia Gatti (0000-0002-3715-0956, University of Parma), Giacomo Biasucci (0000-0002-7441-9248, Guglielmo da Saliceto Hospital), Susanna Esposito (0000-0003-4103-2837, University of Parma, autor correspondente)
Ano2022
Volume9
Fascículo2
Páginas128-128
Data de publicação2022-01-19
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoChildren (JOURNAL)
Identificadores do periódicoISSN: 2227-9067 • E-ISSN: 2227-9067
EditoraMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/children9020128
PMID35204849
OpenAlexW4205463785
IdiomaEN
Referências citadas32

With the spread of antibiotic resistance in pediatric urinary tract infections (UTIs), more patients are likely to be started empirically on antibiotics to which pathogens are later found to be resistant (discordant therapy). However, in-vivo effectiveness may be different from in-vitro susceptibility. Aims of this study were to describe clinical outcomes of discordant empirical treatments in pediatric UTIs and to investigate risk factors associated to treatment failure. This observational, retrospective study was conducted on children hospitalized for febrile UTIs with positive urine culture and started on discordant empirical therapy. Failure rates of discordant treatments and associated risk factors were investigated. A total of 142/1600 (8.9%) patients were treated with inadequate empirical antibiotics. Clinical failure was observed in 67/142 (47.2%) patients, with no fatal events. Higher failure rates were observed for combinations of penicillin and beta-lactamase inhibitors (57.1%). Significant risk factors for failure of discordant treatment were history of recurrent UTIs (95% CI: 1.13-9.98, OR: 3.23, p p Pseudomonas aeruginosa (95% CI: 1.85-62.10, OR: 7.30, p p = 0.05). This study showed that discordant empirical treatments may still be effective in more than half of pediatric UTIs. Clinical effectiveness varies between different discordant antibiotics in pediatric UTIs, and patients presenting risk factors for treatment failure may need a differentiated empirical approach

Antibiotics · Biology · Intensive care medicine · Observational study · Penicillin · Retrospective cohort study · Urinary system · Medicine · Pediatric Urology and Nephrology Studies · Urinary Bladder and Prostate Research · Urinary Tract Infections Management · Internal Medicine · Microbiology · Pediatrics