A urinary tract infection, or UTI, may involve either the upper or lower parts of the urinary tract--the kidneys; the ureters, which are the tubes connecting the kidneys to the bladder; or the bladder itself. A UTI can lead to some long-term consequences, such as scars on the kidney and kidney problems. Because of this, it is important to treat this common problem of childhood with the appropriate antibiotics. Several antibiotics may be considered as "first-line," or the first choice, in treatment.
Cefepime
Cefepime is an example of an antibiotic that is categorized as a cephalosporin. It is sub-categorized as either a third- or fourth-generation cephalosporin, which means that it has more activity against gram negative bacteria and less activity against gram positive bacteria. According to the medical reference UpToDate, cefepime is considered to be one of the best choices to treat both uncomplicated and complicated urinary tract infections because it works against a variety of bacteria that may cause UTIs, including, E. coli, the bacteria that causes 80 percent of UTIs in children. Cefepime cannot be taken by mouth, and must be given via an injection or an intravenous line (IV). Children given cefepime for a UTI may experience some irritation and redness at the site of the injection, increases in levels of liver enzymes, rashes, nausea and vomiting, headaches, and fevers. Serious complications that may occur include the development of an intestinal infection called pseudomembranous colitis as well as seizures and coma.
Gentamicin
The antibiotic gentamicin belongs to a class of antibiotics called the aminoglycosides. This group of antibiotics works against bacteria by interfering with their ability to replicate. Gentamicin is effective against a range of bacteria, most of which are gram negative. Examples of UTI-causing bacteria that can be killed by this antibiotic include Proteus species as well as gram-positive Staphylococcus. Like cefepime, gentamicin must be delivered either by injection or intravenously. It may cause several different types of side effects. According to MedlinePlus from the National Institutes of Health, gentamicin use may result in nausea or stomach upset, feeling extremely tired and fatigued, and vomiting. The medical reference UpToDate includes other possible side effects that range from relatively mild to severe, including pain at the injection site, fever, liver enzyme changes, kidney failure and weakness.
Ampicillin
While many UTIs in children are caused by the bacteria E. coli, in certain circumstances other organisms may be responsible for the infection. One such special situation involves children who have had a urinary catheter placed in the bladder. This is small, thin, tube that is inserted into the bladder to it of urine. Children who are being hospitalized may have such a catheter placed. Catheter placement increases the risk for a UTI because the catheter is a good environment for bacteria, and occasionally fungus, to grow. One organism that is associated with catheter-associated UTI is called Enterococcus. In such cases, a good treatment option is ampicillin, as long as the bacteria is not resistant to it. Ampicillin is a penicillin-based antibiotic that may be given via an injection or intravenously but can also be taken by mouth. UpToDate lists a variety of possible side effects including rashes, fever, diarrhea and anemia.
References
- "UpToDate"; Acute management, imaging, and prognosis of urinary tract infections in children N. Shaikh and A. Hoberman; March 2010
- MedlinePlus: Gentamicin Sulfate Injection
- MedlinePlus: Catheter-Associated UTI
- "UpToDate"; Ampillicin: Pediatric Drug Information; Lexi-Comp, Inc.; 2010
- "UpToDate"; Gentamicin: Drug Information; Lexi-Comp, Inc.; 2010
