BAL HARBOUR, FLA.— Concentrate on Escherichia coli susceptibility when selecting therapy for initial and first recurrent urinary tract infections in children, Sarah Long, M.D., advised at the annual Masters of Pediatrics conference sponsored by the University of Miami.
About 95% of initial UTIs are caused by E. coli, as are most first recurrences, said Dr. Long, chief of the section of infectious disease at Christopher. St's Hospital for Children, Philadelphia.
Other causes of the UTIs generally result from abnormal circumstances, such as dysfunctional voiding, she noted.
Antibiotic resistance is an increasing problem in the treatment of UTIs, so keep this in mind when selecting a drug.
Only about 30% of cases are susceptible to ampicillin and amoxicillin, so these drugs are “off the list,” according to Dr. Long.
Trimethoprim-sulfamethoxazole is also on its way out; only about 50%-80% of cases are susceptible to this treatment, depending on the geographical area.
“I think this is fading as a first drug [for UTIs],” she said.
First-generation cephalosporins, such as cephalexin, and second-generation cephalosporins, such as cefuroxime, remain good choices for treatment, with susceptibility ranging from 95% to 100%.
Third-generation cephalosporins should not be used first for a UTI, Dr. Long stated.