PLoS ONE (Jan 2021)

Relay oral therapy in febrile urinary tract infections caused by extended spectrum beta-lactamase-producing Enterobacteriaceae in children: A French multicenter study.

  • Gabriel Lignieres,
  • André Birgy,
  • Camille Jung,
  • Stéphane Bonacorsi,
  • Corinne Levy,
  • François Angoulvant,
  • Emmanuel Grimprel,
  • Marie Aliette Dommergues,
  • Yves Gillet,
  • Irina Craiu,
  • Alexis Rybak,
  • Loic De Pontual,
  • François Dubos,
  • Emmanuel Cixous,
  • Vincent Gajdos,
  • Didier Pinquier,
  • Isabelle Andriantahina,
  • Valérie Soussan-Banini,
  • Emilie Georget,
  • Elise Launay,
  • Olivier Vignaud,
  • Robert Cohen,
  • Fouad Madhi

DOI
https://doi.org/10.1371/journal.pone.0257217
Journal volume & issue
Vol. 16, no. 9
p. e0257217

Abstract

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ObjectivesWe need studies assessing therapeutic options for oral relay in febrile urinary tract infection (FUTI) due to ESBL-producing Enterobacteriaceae (ESBL-E) in children. Amoxicillin-clavulanate/cefixime (AC-cefixime) combination seems to be a suitable option. We sought to describe the risk of recurrence at 1 month after the end of treatment for FUTI due to ESBL-E according to the oral relay therapy used.Materials and methodsWe retrospectively identified children ResultsWe included 199 children who received an oral relay therapy with cotrimoxazole (n = 72, 36.2%), ciprofloxacin (n = 38, 19.1%) or the AC-cefixime combination (n = 89, 44.7%). Nine (4.5%) patients had a recurrence within the first month after the end of treatment, with no difference between the 3 groups of oral relay (p = 0.8): 4 (5.6%) cotrimoxazole, 2 (5.3%) ciprofloxacin and 3 (3.4%) AC-cefixime combination. Phenotype characterization of 249 strains responsible for FUTI due to ESBL-E showed that 97.6% were susceptible to the AC-cefixime combination.ConclusionsThe AC-cefixime combination represents an interesting therapeutic option for oral relay treatment of FUTI due to ESBL-E as the recurrence rate at 1 month after the end of treatment was the same when compared to cotrimoxazole and ciprofloxacin.