Hennaut Elise, Duong Hong P, Chiodini Benedetta, Adams Brigitte, Lolin Ksenija, Blumental Sophie, Wissing Karl M, Ismaili Khalid
Department of Pediatric Nephrology, Hôpital Universitaire des Enfants - Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium.
Department of Infectious Diseases, Hôpital Universitaire des Enfants - Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium.
Front Pediatr. 2018 Aug 31;6:237. doi: 10.3389/fped.2018.00237. eCollection 2018.
To assess the safety and efficacy of ambulatory oral cefuroxime-axetil treatment in children presenting with first febrile urinary tract infection (UTI) in terms of resolution of fever, antibiotics tolerance, bacterial resistance, and loss to ambulatory follow-up. Two-year prospective single-center evaluation of the local protocol of oral ambulatory treatment of children presenting first febrile urinary tract infection (UTI). From October 2013 to October 2015, 82 children were treated ambulatory with oral cefuroxime-axetil. The median age was 8 months. When analyzing those 82 children treated orally, 51 (62%) completed oral treatment, 14 (17%) missed their scheduled follow-up visits (3 patients at day 2 and 11 patients at week 2), and 17 (21%) were switched to IV therapy for the following reasons: vomiting in 9, persistent fever in 5, antibiotic resistance in 2 and bacteremia in 1. Six children (8%) presented recurrent UTI after a median of 5 months of follow-up. This 2-year evaluation suggests that oral treatment with cefuroxime-axetil in febrile UTI is feasible but should be implemented with caution. Home-treated children require reevaluation during treatment since 21% of our cohort had to be temporarily switched to parenteral therapy and 17% did not attend scheduled follow-up visits during oral treatment.
评估门诊口服头孢呋辛酯治疗首次发热性尿路感染（UTI）患儿的安全性和有效性，内容涉及发热消退情况、抗生素耐受性、细菌耐药性以及门诊随访失访情况。对当地门诊口服治疗首次发热性尿路感染（UTI）患儿的方案进行为期两年的前瞻性单中心评估。2013年10月至2015年10月，82例患儿接受了门诊口服头孢呋辛酯治疗。中位年龄为8个月。在分析这82例接受口服治疗的患儿时，51例（62%）完成了口服治疗，14例（17%）未按计划进行随访（第2天有3例，第2周有11例），17例（21%）因以下原因改为静脉治疗：9例呕吐，5例持续发热，2例抗生素耐药，1例菌血症。6例患儿（8%）在中位随访5个月后出现复发性UTI。这项为期两年的评估表明，口服头孢呋辛酯治疗发热性UTI是可行的，但应谨慎实施。在家接受治疗的患儿在治疗期间需要重新评估，因为我们队列中有21%的患儿不得不暂时改为肠外治疗，17%的患儿在口服治疗期间未按计划进行随访。
