Piperacillin−tazobactam versus cefotaxime as empiric treatment for febrile urinary tract infection in children

Abstract

Urinary tract infections (UTI) are one of the most common infections in children. The proportion of extended − spectrum beta − lactamase (ESBL) − producing bacteria in pediatric UTIs is increasing. Therefore, it is necessary to pay attention to the use of antibiotics to prevent ESBL − producing bacteria in patients susceptible to infections in medical institutions. This study aimed to investigate the clinical features related to the recurrence of UTI in children and to confirm the experience and validity of piperacillin − tazobactam (TZP) as a first − line treatment. Medical records of pediatric patients diagnosed with febrile UTI between January 2014 and February 2017 were retrospectively reviewed. Patients were grouped according to the antimicrobials they received. Clinical characteristics and treatment outcomes in terms of recurrent UTI were compared between the groups. Our findings demonstrate significant variations in the clinical characteristics of UTIs depending on the age of onset. Further, we found that 18.3% of community − acquired UTIs were caused by ESBL − positive bacteria. Regarding the empiric treatment for febrile UTI in children ≥ 3 months, there was no significant difference in recurrence between the cefotaxime − treated group and TZP − treated group. Thus, TZP can be considered an alternative to cefotaxime for febrile UTI in infants and children ≥ 3 months of age.