First generation cephalosporins as therapy for uncomplicated pyelonephritis in children. A retrospective analysis.

There is no consensus opinion for the optimal management of pyelonephritis in children. We summarized our experience with first generation cephalosporins by a retrospective analysis of 129 pediatric patients with pyelonephritis who were treated either by first generation cephalosporins (97 patients, group 1) or broad-spectrum antibiotics (32 patients, group 2). Group 1 patients were less likely to have reported previous urinary infections or anatomical urinary tract abnormalities (16.2% vs. 53.1%, p= 0.002) and pathogens other than E. coli (7.3% vs. 25%, p=0.02). Resistance to first generation cephalosporins was identified in 22.6% of pathogens cultured, however, only 7.5% of them had poor clinical responses and required alternative treatment replacement. Our findings show that first generation cephalosporins could be used in our region to treat pyelonephritis in an otherwise healthy child, and that they can provide therapeutic success even in the face of apparent bacterial resistance.