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Archivos de Pediatría del Uruguay

Print version ISSN 0004-0584On-line version ISSN 1688-1249

Abstract

ROBINO, Luciana et al. Fosfomycin for low urinary-tract infections in children of over 6 years of age. Clínical-microbiological evolution. Arch. Pediatr. Urug. [online]. 2020, vol.91, suppl.2, pp.24-33.  Epub Dec 01, 2020. ISSN 0004-0584.  https://doi.org/10.31134/ap.91.s2.3.

Introduction:

fosfomycin tromethamine (FT) is an alternative to the treatment of low urinary tract infection (UTI). Uruguay does not have information about its use in children.

Objective:

to describe the clinical and microbiological evolution of a cohort of children older than 6 years of age with low UTI treated with FT.

Materials and methods:

we included children of over 6 years of age with low UTI from two health providers in Montevideo between 2/1/2018 and 6/30/2019. We prescribed a single dose of FT 2 g and a control urine culture to all patients. We carried out a telephone follow-up and assessed their clinical record, history of UTI, microorganisms, antimicrobial susceptibility and evolution: time of clinical resolution, microbiological resolution, adverse effects, and recurrence during the first 3 months.

Results:

46 children were included, median age 9.4 years, history of UTI 13. 44 presented dysuria, 33 tenesmus, 31 pollakiuria. Isolated microorganism: E. coli 43, S. saprophyticus 2, Proteus sp 1. All susceptible to FT, except S. saprophyticus, naturally resistant. Clinical resolution in 48 hours: 42. Control urine culture was obtained in 31/46 children: microbiological resolution 22, no resolution 5 and contaminated 4. Adverse effects 9: vomiting 1, diarrhea 8, and headache 1. Telephone follow-up carried out for 40 / 46 patients: reinfections after one month of treatment: 6.

Conclusions:

microorganisms had not acquired resistance. Most cases showed clinical resolution during the first 48 hours. Adverse effects were mild. Reinfections occurred in a small proportion. The results support FT as a therapeutic alternative for low UTI for the case of children of over 6 years of age.

Keywords : Fosfomycin; Urinary tract infections; Microbial drug resistance; Child.

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