تاثير تجويز سوسپانسيون سفيكسيم در درمان سرپايي پيلونفريت حاد كودكان

The Effect of Cefixime Suspension in Out patient Therapy of Children with Acute Pyelonephritis

Background: Urinary tract infection (UTI) is one of the commonest infections among infants and children. The availability of potent, oral, third-generation cephalosporins is a good way for avoidance of hospitalization and nosocomial infections and reduction of the costs. Thus, this study was carried out to determine the efficacy of cefixime suspension in children with acute pyelonephritis in kermanshah during p02-2004. Materials and Methods: In this clinical trial 60 children with fever and urinary tract infection were studied. The first group (30 patients) was treated with cefixime suspension (8 mg/kg) for 14 days (7 days at hospital and 7 days at home). The second group was treated with ampicillin (100mg/kg) and gentamicin (2.5 mg/kg) for 7 days followed by a 7 - day treatment with oral co-trimoxazol (7-10 mg/kg). Response to treatment was evaluated through sterility of urine culture and defervescence, and also possible complications including number of infection recurrences and renal scarring. The data were analyzed using chiʹ test. Results: The results revealed that urine culture was still positive in 9 patients (30%) in cefixime-treated group and in 1 patients (3.3%) in standard- treated group (p= 0.012). Defervescence time for both groups was 48-60 hours. Recurrence in cefixime-treated patients and standard- treated patients were 16.7% and 10% respectively, showing no significant difference. Renal scarring after 6 months of treatment with cefixime was 8.3%, and 7.1% in children treated with standard method (p=0.08). Conclusion: Regarding 30% treatment failure in cefixime-treated patients, administration of this medicine in out-patient therapy of acute pyelonephritis is not recommended. Further research is suggested.