Ampicillin Sulbactam Monotherapy in Infants with febrile Uri
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Cephalosporin is the most commonly used empirical agent for urinary tract infection in children. However, increasing use of cephalosporins can lead to an increase in resistant pathogens. Therefore, this study aims to investigate the effects of monotherapy with ampicillin sulbactam as an alternative to cephalosporins.

All 2 to 24 months old patients who were hospitalized due to first episode of febrile UTI during the 2 year period were included in the study. The subjects were divided into two groups according to their empirical therapy cefotaxime or ampicillin sulbactam. Patients UTI pathogens and their antibiotic susceptibilities were determined and the effectiveness and the occurrence of adverse effects of ampicillin sulbactam and cephalosporin therapy were compared.

46 patients were treated with cefotaxime (group A) and 41 patients with ampicillin sulbactam as empirical antibiotic (group B). The most common pathogen in both groups was Escherichia coli, and antibiotic susceptibilities of the bacterial strains isolated from both groups were similar in ampicillin sulbactam and cefotaxime. In addition, there was no significant difference in the duration of fever after treatment between the two groups (Group A: 2.0 vs. Group B: 3.0). There were no treatment failures and no recurrence in either group, even in patients with resistant pathogens. The most common side effect of the antibiotic agents was diarrhoea.

Ampicillin sulbactam could be an effective alternative to cephalosporin as empiric antibiotic for the treatment of first episode UTI in patients under 24 months of age.

source: https://onlinelibrary.wiley.com/doi/abs/10.1111/ped.14454?af=R
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