The National Kidney and Urologic Diseases Information Clearinghouse estimates that each year about 3 percent children in the United States are affected by urinary tract infections (UTIs). Antibiotics are the drugs of choice to treat and manage UTIs in children, and the initial treatment involves a broad-spectrum antibiotic that is effective against several types of bacteria. More specific antibiotics are prescribed once the laboratory tests determine the exact causative agent. The length of the treatment, the daily schedule and the type of antibiotic also depend on other factors, such as the severity of the condition and patient allergies.
Beta-lactam Antibioitcs
Beta-lactams, such as ampicillin and amoxicillin, have traditionally been used to treat UTIs in children including infants and young children between 2 months and 2 years of age. The antibiotic is usually taken orally, and the course of the therapy lasts for 7 to 14 days. However, the American Academy of Pediatrics (AAP) recommends intravenous administration for the initial 24 to 48 hours or until the condition of the child improves. This should be followed orally to complete the 7 to 14 day course.
Common side effects include upset stomach, vomiting, and diarrhea. It is important to call the doctor immediately if the child develops severe skin rash, seizures, yellowing of the skin or eyes, unusual bleeding or pale skin.
Trimethoprim/Sulfamethoxazole (TMP/SMX)
According to the AAP, E. coli is the most common cause of UTIs in children, and emerging resistance of E. coli to beta-lactam antibiotics has prompted doctors to use the combination drug which contains trimethoprim and sulfamethoxazole (TMP/SMX) as an alternative. In fact, the AAP estimates that TMP/SMX has higher cure rates (4% to 42%) compared with ampicillin and amoxicillin, regardless of the duration of therapy.
TMP/SMX can be taken orally or intravenously for 7 to 14 days, depending on the condition of the child. Upset stomach, vomiting, and loss of appetite are the common side effects. It is important to call the doctor if the child develops skin rash, sore throat, fever or chills, mouth sores or unusual bruising and bleeding.
Cephalosprorins
First, second, and third generation cephalosporins, such as cefixime and cephalexin, are effective alternatives to beta-lactams and TMP/SMX. In an abstract published in the AAP Medical Conference and Exhibition website, Dr. Hillary Copp states that the use of third generation cephalosporins has increased from 12% to 25% of all the antibiotic prescriptions for pediatric UTIs.
Side effects commonly involve the digestive system and may include stomach cramps, nausea, vomiting and diarrhea. These side effects are usually mild and go away over time, but it is important to contact the physician if the problems persist.
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