Cefine (Cefixime)

Recommendations by the Pediatric Infectious Diseases Group of the French Pediatrics Society and the French-Language Infectious Diseases Society for the management of urinary tract infections in children

The Pediatric Infectious Diseases Group of the French Pediatrics Society and the French-Language Infectious Diseases Society recommend the following for the management of urinary tract infections in children:

• For screening of urinary tract infections (UTI) in febrile infants and children, urine dipsticks have to be used more frequently
• Other methods of sampling urine culture should be employed
• for confirmation of UTI than the urine bag such as sampling jet, urethral catheterization, or pubic puncture
• The use of carbapenems as the first-line treatment makes the patients vulnerable to the risk of untreatable infections
• In case of febrile UTI, the expert group recommended:
  • Approbation of the initial treatment with aminoglycosides (particularly amikacin) for majority of ESBL strains of patients seen in the pediatric emergency department and/or hospital
  • Owing to the low percentage of ESBL-producing enterobacteria strains, ceftriaxone (IV or IM) is favored as an appropriate treatment for patients seen in the emergency department or outpatient clinic
  • Oral cefixime use can be advocated in non-severe cases and low-risk patients defined as age>3 months, general condition preserved, duration of fever<4 days, no associated comorbidity, and no history of UTI, uropathy, or prior antibiotic therapy in the last 3 months
  • In-vitro susceptibility testing is used to guide the oral relay for parenteral treatment to reduce the use of oral cephalosporins in order to limit the selection of resistant bacterial strains