Clinical Outcome of Discordant Empirical Therapy and Risk Factors Associated to Treatment Failure in Children Hospitalized for Urinary Tract Infections.
antibiotic failure
antibiotic resistance
discordant antibiotic
empirical therapy
urinary tract infections
Journal
Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936
Informations de publication
Date de publication:
19 01 2022
19 01 2022
Historique:
received:
11
12
2021
revised:
08
01
2022
accepted:
13
01
2022
entrez:
25
2
2022
pubmed:
26
2
2022
medline:
26
2
2022
Statut:
epublish
Résumé
With the spread of antibiotic resistance in pediatric urinary tract infections (UTIs), more patients are likely to be started empirically on antibiotics to which pathogens are later found to be resistant (discordant therapy). However, in-vivo effectiveness may be different from in-vitro susceptibility. Aims of this study were to describe clinical outcomes of discordant empirical treatments in pediatric UTIs and to investigate risk factors associated to treatment failure. This observational, retrospective study was conducted on children hospitalized for febrile UTIs with positive urine culture and started on discordant empirical therapy. Failure rates of discordant treatments and associated risk factors were investigated. A total of 142/1600 (8.9%) patients were treated with inadequate empirical antibiotics. Clinical failure was observed in 67/142 (47.2%) patients, with no fatal events. Higher failure rates were observed for combinations of penicillin and beta-lactamase inhibitors (57.1%). Significant risk factors for failure of discordant treatment were history of recurrent UTIs (95% CI: 1.13-9.98, OR: 3.23,
Identifiants
pubmed: 35204849
pii: children9020128
doi: 10.3390/children9020128
pmc: PMC8870639
pii:
doi:
Types de publication
Journal Article
Langues
eng
Investigateurs
Alberto Argentiero
(A)
Giovanni Autore
(G)
Luca Bernardi
(L)
Giulia Dal Canto
(G)
Cosimo Neglia
(C)
Ivana Cortina
(I)
Maria Elena Capra
(ME)
Consuelo Benincasa
(C)
Agnese Addeo
(A)
Rosa Elisa Saia
(RE)
Francesca Lelli
(F)
Andrea Pession
(A)
Andrea Pasini
(A)
Francesco Baccelli
(F)
Laura Bruni
(L)
Giulia Gallotta
(G)
Adelaide Corvaglia
(A)
Marcello Lanari
(M)
Agnese Suppiej
(A)
Claudia Cafolla
(C)
Federica Boselli
(F)
Enrico Valletta
(E)
Vittorio Venturoli
(V)
Luca Casadio
(L)
Ilaria Polenzani
(I)
Federico Marchetti
(F)
Alessandro De Fanti
(A)
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