1. Relay oral therapy in febrile urinary tract infections caused by extended spectrum beta-lactamase–producing Enterobacteriaceae in children: A French multicenter study
- Author
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Vincent Gajdos, André Birgy, Isabelle Andriantahina, Didier Pinquier, Valérie Soussan-Banini, Elise Launay, Olivier Vignaud, Yves Gillet, Alexis Rybak, Emmanuel Grimprel, Loïc de Pontual, Corinne Levy, François Angoulvant, Emilie Georget, Irina Craiu, François Dubos, Gabriel Lignieres, Marie Aliette Dommergues, Robert M. Cohen, Camille Jung, Emmanuel Cixous, Fouad Madhi, Stéphane Bonacorsi, Centre Hospitalier Intercommunal de Créteil (CHIC), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier de Versailles André Mignot (CHV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Centre Hospitalier de Saint-Camille [Bry sur Marne], Hôpital Ambroise Paré [AP-HP], and Centre Hospitalier Intercommunal Villeneuve-Saint-Georges (CHIV)
- Subjects
Male ,Physiology ,Klebsiella pneumoniae ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Antibiotics ,Administration, Oral ,Urine ,Geographical locations ,Families ,Ciprofloxacin ,Recurrence ,Medicine and Health Sciences ,Child ,Children ,Routes of Administration ,Multidisciplinary ,biology ,Antimicrobials ,Drugs ,Body Fluids ,Europe ,Phenotype ,Treatment Outcome ,Child, Preschool ,Urinary Tract Infections ,Medicine ,Female ,France ,Anatomy ,Research Article ,medicine.drug ,Risk ,medicine.medical_specialty ,Adolescent ,Fever ,medicine.drug_class ,Science ,Urinary system ,Microbial Sensitivity Tests ,Amoxicillin-Potassium Clavulanate Combination ,Microbiology ,Antibiotic Susceptibility Testing ,beta-Lactamases ,Enterobacteriaceae ,Cefixime ,Microbial Control ,Intravenous Injections ,Internal medicine ,Trimethoprim, Sulfamethoxazole Drug Combination ,medicine ,Humans ,European Union ,Etest ,Retrospective Studies ,Pharmacology ,Bacteria ,business.industry ,Organisms ,Infant, Newborn ,Biology and Life Sciences ,Infant ,Renal System ,bacterial infections and mycoses ,biology.organism_classification ,Pharmacologic Analysis ,Age Groups ,People and Places ,Beta-lactamase ,Population Groupings ,business - Abstract
ObjectivesWe need studies assessing therapeutic options for oral relay in febrile urinary tract infection (FUTI) due to ESBL–producing Enterobacteriaceae (ESBL-E) in children. Amoxicillin-clavulanate/cefixime (AC-cefixime) combination seems to be a suitable option. We sought to describe the risk of recurrence at 1 month after the end of treatment for FUTI due to ESBL-E according to the oral relay therapy used.Materials and methodsWe retrospectively identified children ResultsWe included 199 children who received an oral relay therapy with cotrimoxazole (n = 72, 36.2%), ciprofloxacin (n = 38, 19.1%) or the AC-cefixime combination (n = 89, 44.7%). Nine (4.5%) patients had a recurrence within the first month after the end of treatment, with no difference between the 3 groups of oral relay (p = 0.8): 4 (5.6%) cotrimoxazole, 2 (5.3%) ciprofloxacin and 3 (3.4%) AC-cefixime combination. Phenotype characterization of 249 strains responsible for FUTI due to ESBL-E showed that 97.6% were susceptible to the AC-cefixime combination.ConclusionsThe AC-cefixime combination represents an interesting therapeutic option for oral relay treatment of FUTI due to ESBL-E as the recurrence rate at 1 month after the end of treatment was the same when compared to cotrimoxazole and ciprofloxacin.
- Published
- 2021