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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Lignieres, Gabriel, Birgy, André, Jung, Camille, Bonacorsi, Stéphane, Levy, Corinne, Angoulvant, François, Grimprel, Emmanuel, Dommergues, Marie Aliette, Gillet, Yves, Craiu, Irina, Rybak, Alexis, De Pontual, Loic, Dubos, François, Cixous, Emmanuel, Gajdos, Vincent, Pinquier, Didier, Andriantahina, Isabelle, Soussan-Banini, Valérie, Georget, Emilie, and Launay, Elise
- Subjects
BETA lactamases ,URINARY tract infections ,ORAL drug administration ,ENTEROBACTERIACEAE ,CO-trimoxazole ,CIPROFLOXACIN ,PHENOTYPES - Abstract
Objectives: We 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 methods: We retrospectively identified children <18 years who were included in a previous prospective observational multicentric study on managing FUTI due to ESBL-E between 2014 and 2017 in France. We collected whether children who received cotrimoxazole, ciprofloxacin or the AC-cefixime combination as the oral relay therapy reported a recurrence within the first month after the end of treatment. Then, we analyzed the susceptibility drug-testing of the strains involved. Results: We 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. Conclusions: The 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. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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