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ID 44648
本文ファイル
著者
Nomura, Toshihito
Hisata, Ken
Toyama, Yudai
Sakaguchi, Keita
Igarashi, Naru
Nakao, Akihiro
Matsunaga, Nobuaki
Komatsu, Mitsutaka
Obinata, Kaoru
Shimizu, Toshiaki
キーワード
Prophylaxis
breakthrough-urinary tract infection
NDC
医学
抄録(英)
Antimicrobial prophylaxis using cefaclor or trimethoprim-sulfamethoxazole (co-trimoxazole) is recommended for children with vesicoureteral reflex (VUR) to prevent recurrent urinary tract infection (UTI). This retrospective study was performed by reviewing the data of children ≥5 years of age treated for recurrent UTI in six hospitals from 2010 to 2015. The criteria for UTI diagnosis is fever (≥38°C) and positive results in urine culture (>104 colony-forming units/ml in midstream or withdrawn urine specimens). In total, 41 children were reviewed, and 31 children had recurrent UTI without antimicrobial prophylaxis and 10 had breakthrough (BT)-UTI treated with prophylaxis using cefaclor or co-trimoxazole. In the cases of BT-UTI treated with prophylaxis, 5 children received cefaclor and 5 received co-trimoxazole. We collected data on pathogens, antimicrobial resistance, and antimicrobial agents chosen for the empirical treatment of recurrent UTI. We also evaluated the validity of empirical therapy for recurrent UTI in this study. Various pathogens were found in children who received prophylaxis with cefaclor. The rate of empirical antimicrobial agents that were inappropriate based on antimicrobial susceptibility tests was higher in children who received prophylaxis with cefaclor (60.0%) than in those who received no prophylaxis (25.9%) or prophylaxis with co-trimoxazole (20.0%). Prophylaxis with cefaclor was found to be a risk factor for inappropriate empirical treatment in BT-UTI cases. The results suggest that the choice of empirical antimicrobial agents in BT-UTI cases should be carefully considered before treatment with prophylaxis. To encourage the adequate use of antimicrobial agents, we recommend prophylaxis with co-trimoxazole to prevent recurrent UTI.
掲載誌名
Hiroshima Journal of Medical Sciences
66巻
2号
開始ページ
39
終了ページ
44
出版年月日
2017-08
出版者
Hiroshima University Medical Press
ISSN
0018-2052
2433-7668
NCID
出版者DOI
言語
英語
NII資源タイプ
紀要論文
広大資料タイプ
学内刊行物(紀要等)
DCMIタイプ
text
フォーマット
application/pdf
著者版フラグ
publisher
権利情報
Copyright (c) 2017 Hiroshima University Medical Press
関連情報URL
部局名
医歯薬保健学研究科
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