Abstract:

Urinary tract infections (UTIs) are among the most common bacterial infections in children. Selection of empirical antibiotic therapy is based on patient characteristics and regional antibiotic resistance patterns. Antibiotic resistance driven by inappropriate antibiotic use remains a major public health concern. The aim of this study was to compare the microbiological spectrum of pediatric acute pyelonephritis and antimicrobial resistance patterns in two time periods 5 years apart. The patients with acute acute pyelonephritis, clinical characteristics, treatment modalities, causative uropathogens and their antibiotic susceptibility and resistance patterns were compared between the two time periods. Results: Group 1 included 86 children (mean age 3.52 ± 0. 4 years, 32 boys) hospitalized for acute pyelonephritis in 2012-2013; group 2 included 72 children (mean age 3.78 ± 0.7 years, 25 boys) in 2017-2018. Escherichia coli was the most common microorganism in both groups. The most frequently used antibiotics for pyelonephritis treatment in both groups were amikacin and ceftriaxone. While 77% of the children in group 1 used prophylactic antibiotics, this rate was 23% significantly lower in group 2. Resistance to ampicillin, cefepime and ceftriaxone were significantly lower ingroup 2. Ceftriaxone resistance,decreased from 60% to 37%. DISCUSSION AND CONCLUSION: Our study revealed significant reductions in resistance to several antibiotics, ceftriaxone, in a 5-year period. Possible explanations for these results may be that aminoglycosides are preferred more frequently than ceftriaxone therapy, prophylactic treatment is limited in selected cases, and cephalosporins are not used for prophylaxis. We believe that rational empirical antibiotic selection will prevent the development of resistance in UTIs.

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