Single-dose amikacin treatment of first childhood E. coli lower urinary tract infections

Linda Wallen, W. Patrick Zeller, Mary Goessler, Edward Connor, Ram Yogev*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Urinary tract infection in children is usually treated with orally administered antibiotics for 10 to 14 days. Because of the unreliability of patient compliance with prescribed medications and because single-dose aminoglycoside therapy has been shown to be effective in women with cystitis, we assessed the efficacy of single-dose amikacin for treatment of first episodes of Escherichia coli lower urinary tract infection in girls. Upper and lower urinary tract infections were presumptively differentiated by simple criteria such as clinical symptoms, fever, and erythrocyte sedimentation rate. Fifty-four girls (ages 1 to 12 years) with two positive urine cultures (>105 CFU/ml E. coli) were assigned by a table of random numbers to receive treatment with either sulfisoxazole 150 mg/kg/day orally for 10 days or a single dose of amikacin 7.5 mg/kg intramusculary. Six of 23 patients (26%) in the amikacin group and four of 21 (19%) in the sulfisoxazole group had at least one positive urine culture within 40 days after completion of therapy. This difference was not statistically significant (P>0.5). This suggests that a single dose of amikacin is as effective as a 10-day course of sulfisoxazole in the treatment of presumed first lower urinary tract infection in girls. Additional potential advantages of single-dose therapy are fewer side effects and less toxicity, excellent complicance, and reduced potential for selecting resistant organisms.

Original languageEnglish (US)
Pages (from-to)316-319
Number of pages4
JournalThe Journal of pediatrics
Volume103
Issue number2
DOIs
StatePublished - Aug 1983

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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