Clinical Outcomes of Children With Extended-spectrum ß -Lactamase Urinary Tract Infection Receiving Discordant Empiric Antibiotic: A Comparative Study of Fever Duration, Length of Stay, and Readmissions

There has been a recent increase in the incidence of urinary tract infections (UTIs) caused by extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae, which are resistant to third-generation cephalosporins. Our goal was to compare the clinical responses of patients with ESBL UTI and no...

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Bibliographic Details
Published in:Clinical pediatrics 2023-05, Vol.62 (4), p.338-344
Main Authors: Begaj, Xhesika, Lee, Hannah, Noor, Asif, Fiorito, Theresa, Agarwalla, Vipin, Kambhampati, Ooha, Islam, Shahidul, Krilov, Leonard R.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antibiotics
beta-Lactamases
Cephalosporins
Child
Children
Clinical outcomes
Comparative studies
Enterobacteriaceae
Fever
Humans
Length of Stay
Patient Readmission
Patients
Pediatrics
Retrospective Studies
Risk Factors
Urinary tract
Urinary Tract Infections - drug therapy
Urinary Tract Infections - epidemiology
β Lactamase
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Summary:There has been a recent increase in the incidence of urinary tract infections (UTIs) caused by extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae, which are resistant to third-generation cephalosporins. Our goal was to compare the clinical responses of patients with ESBL UTI and non-ESBL UTI who received empiric third-generation cephalosporins. A retrospective analysis was performed on data collected between June 1, 2013, and June 30, 2017, from children aged 0 days to 19 years old who presented to NYU Langone Long Island Hospital’s pediatric ED and/or were admitted with a UTI caused by Enterobacteriaceae. There was no significant difference in median length of fever duration. However, ESBL patients had significantly longer hospital stays, higher 30-day readmission rate, and higher 7-day revisit rate. It is reasonable to maintain an empiric UTI antibiotic choice rather than selecting a broad-spectrum antibiotic, such as carbapenem for children at high risk of ESBL UTI.
ISSN:0009-9228
1938-2707
DOI:10.1177/00099228221129029