SINGLE DOSE CEFTRIAXONE FOR AFEBRILE URINARY TRACT INFECTIONS IN CHILDREN

L. Kovacevic^*, V. Tasic^**, N. Ristoska-Bojkovska^**, S. Todorovska^**

Dept. of Paediatris, ^* Zrenjanin, Yugoslavia. ^** Paediatric Clinic, Skopje, Macedonia

OBJECTIVE. Our previous works pointed out that in our community cotrimoxasole is inefficient in children with urinary tract infection (UTI) due to high percentage of resistant strains of E. coli. The disadvantage of nitrofurantoin is its bad palatability; the limited use of other drugs is due to their toxic potential for children or the high price. In this work we evaluated the effect of single dose ceftriaxone (CEF) in 23 children with afebrile urinary tract infection and compared with control group of children treated with cotrimoxasole (CTX).

METHODS. Diagnosis of UTI based on history of dysuria, leukocituria and significant bacterial growth (> 105 cfu/ml). Children with to > 37.5C, or CRP > 5 mg/l were excluded from the study. The children were given a single dose of ceftriaxone 50 mg/kg (maximal dose 1,000 mg). Urine for microscopy and bacteriology was assessed after 1, 7 and 28 days. For comparison, retrospective data were used from 63 consecutive children with UTI, who had been treated with CTX.

RESULTS. Twenty-two children in CEF group cleared and sterilized the urine after 24 hours; thus only one child (4%) was treatment failure. In the CTX group 31 out of 63 children (49%) were treatment failure; this was statistically significant (P = 0.000053, Fisher exact test). No adverse effects were seen in CEF group.

CONCLUSION. In our community CTX should be considered as a second choice drug for children with afebrile UTI. CEF in a single dose of 50 mg/kg is an effective and safe alternative to CTX.