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Urinary tract infection in pediatric patients is a significant clinical issue, affecting approximately 7% of fevered infants and children. [43] If left untreated, the infection can ascend from the bladder to the kidneys, resulting in acute pyelonephritis, which leads to hypertension , kidney scarring , and end-stage kidney disease .
There are also strains of enterococci that have developed resistance to vancomycin referred to as vancomycin resistant enterococcus (VRE). Agents classified as fourth-line (or greater) treatments or experimental therapies could be considered by default to be drugs of last resort due to their low placement in the treatment hierarchy.
Outpatient parenteral antibiotic therapy (OPAT) is used to administer non-oral antibiotics (usually intravenously) without the need for ongoing hospitalisation. OPAT is particularly useful for people who are not severely ill but do require a prolonged course of treatment that cannot be given in oral form. [ 1 ]
The recommended intravenous dosage in adults is 500 mg every 6 hours or 1000 mg every 12 hours, with modification to achieve a therapeutic range as needed. The recommended oral dosage in the treatment of antibiotic-induced pseudomembranous enterocolitis is 125 to 500 mg every 6 hours for 7 to 10 days. [53]
Symptoms from a lower urinary tract infection include suprapubic pain, painful urination , frequency and urgency of urination despite having an empty bladder. [1] Symptoms of a kidney infection, on the other hand, are more systemic and include fever or flank pain usually in addition to the symptoms of a lower UTI. [ 10 ]
Antibiotic synergy is desirable in a clinic sense for several reasons. At the patient level, the boosted antimicrobial potency provided by synergy allows the body to more rapidly clear infections, resulting in shorter courses of antibiotic therapy. [3] Shorter courses of therapy in turn reduce the effects of dose-related toxicity, if applicable ...
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Antibiotics are administered nightly at half the normal therapeutic dose. The specific antibiotics used differ with the age of the patient and include: Amoxicillin or ampicillin – infants younger than 6 weeks; Trimethoprim-sulfamethoxazole (co-trimoxazole) – 6 weeks to 2 months; After 2 months the following antibiotics are suitable:
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