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

• Published in: The Journal of pediatrics Vol. 103; no. 2; pp. 316 - 319
• Main Authors: Wallen, Linda, Zeller, W. Patrick, Goessler, Mary, Connor, Edward, Yogev, Ram
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.08.1983; Elsevier
• Subjects: Amikacin - administration & dosage; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Child; Child, Preschool; Clinical Trials as Topic; Escherichia coli Infections - drug therapy; Female; Humans; Infant; Injections, Intramuscular; Kanamycin - analogs & derivatives; Medical sciences; Pharmacology. Drug treatments; Sulfisoxazole - therapeutic use; Urinary Tract Infections - drug therapy; Urinary system disease; Colibacillosis; Escherichia coli; Single dose; Urinary tract; Intramuscular administration; Infection; Antibiotic; Chemotherapy; Treatment; Aminoglycoside; Bacteriosis; Child
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(83)80376-X

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 (>10 5 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.