Empiric use of cefepime in the treatment of serious urinary tract infections in children

BACKGROUND: Urinary tract infections (UTIs) are common in childhood. They represent a significant proportion (10%) of hospital-acquired infections in children. Bacteria causing UTIs in children vary, depending on the setting (community-acquired vs. nosocomial), underlying anatomic anomalies and concurrent medical conditions. OBJECTIVE: To review published and unpublished clinical studies that have used cefepime for the treatment of UTIs in children. METHODS AND RESULTS: In two recent multicenter, randomized trials, cefepime (50 mg/kg/dose every 8 h and every 12 h) was compared with ceftazidime (50 mg/kg/dose every 8 h) for the treatment of serious urinary tract infections including pyelonephritis in children less than 12 years of age. In these studies a favorable clinical and microbiologic response was observed in >95% of cefepime-treated and ceftazidime-treated children assessed at the end of treatment. CONCLUSIONS: These results indicate that cefepime represents an important therapeutic option for the treatment of serious UTIs in children.