Recurrent Cystitis in Children: Preventive Interventions
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Abstract
The rapidly progressive growth of antibiotic resistance of the main uropathogens, and the side effects of long courses of antibiotic therapy are one of the main problems in the treatment of children with recurrent cystitis. This encourages the search for alternative and effective treatment and prevention regimens for this pathology.
The objective: the study of the regional characteristics of the microbial landscape of urine in children with cystitis; a study of the effectiveness of 7 days of taking the medicine Furamag® in the treatment of cystitis; assessment of the duration of clinical and laboratory remission in children with cystitis.
Materials and methods. The clinical and laboratory examination of 65 children aged 5 to 15 years was conducted. Patients of group I (33 children) received FuramagR as the basis of antimicrobial therapy, 32 children from the comparison group took cefuroxime axetil. The duration of therapy in both groups was 7 days. The second stage of the study was to evaluate the effectiveness of antirelapsing treatment of cystitis in girls aged 7 to 15 years: 1/3 of the therapeutic dose of Furamag® in combination with the vaccine Urivac for 3 months.
Results. Furamag® demonstrated significantly higher bacteriological effectiveness in comparison with cefuroxime axetil for eradication of the most clinically significant causative agents of cystitis detected in thePoltava region. The results of observations in a group of children who received antirelapse treatment with a prophylactic dose of Furamag® in combination with the immunization vaccine Urivac showed high efficacy in clinical and laboratory remission and the safety of using the chosen regimen.
Conclusion. Analysis of all isolated microorganisms demonstrated a significantly higher sensitivity to Furamag® compared with cefuroxime axetil, which was accompanied by a significantly higher eradication rate of the clinically significant cystitis pathogens identified in the study. The results of the high bacteriological effectiveness of Furamag®, the rapid elimination of the main clinical manifestations of the disease, as well as high efficacy in clinical and laboratory remission and the safety of using the Furamag® + Urivac regimen indicate the feasibility of using drugs in the treatment and prevention schemes for relapsing cystitis exacerbations in children.##plugins.themes.bootstrap3.article.details##
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References
Sadeghi Bojd S, Soleimani G, Teimouri A, Aflakian N. Urinary Infection Recurrence and Its Related Factors in Urinary Tract Infection, Int J Infect. 2018; 5(2):e64903. doi: 10.5812/iji.64903.
Nickavar A, Sotoudeh K. Treatment and prophylaxis in pediatric urinary tract infection. Int J Prev Med. 2011 Jan-Mar;2(1):4-9. PubMed PMID: 21448397; PubMed Central PMCID: PMC3063462.
Risk Factors for Recurrent Urinary Tract Infection and Renal Scarring Ron Keren, Nader Shaikh, Hans Pohl, Lisa Gravens-Mueller, Anastasia Ivanova, Lisa Zaoutis, Melissa Patel, Rachel de Berardinis, Allison Parker, Sonika Bhatnagar, Mary Ann Haralam, Marcia Pope, Diana Kearney, Bruce Sprague, Raquel Barrera, Bernarda Viteri, Martina Egigueron, Neha Shah, Alejandro Hoberman Pediatrics Jul 2015, 136 (1) e13-e21; DOI: 10.1542/peds.2015-0409
Brian Becknell, Megan Schober, Lindsey Korbel & John David Spencer (2015) The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections, Expert Review of Anti-infective Therapy, 13:1, 81-90, DOI: 10.1586/14787210.2015.986097
Vachvanichsanong P, Dissaneewate P, McNeil E. Childhood recurrent urinary tract infection in southern Thailand. Ren Fail. 2013;35(1):66-71. doi: 10.3109/0886022X.2012.741647.
Renard J, Ballarini S, Mascarenhas T, et al. Recurrent Lower Urinary Tract Infections Have a Detrimental Effect on Patient Quality of Life: a Prospective, Observational Study [published online ahead of print, 2014 Dec 18]. Infect Dis Ther. 2014;4(1):125–135. doi:10.1007/s40121-014-0054-6
Brandström P, Hansson S. Long-term low-dose prophylaxis for young children. Pediatr Nephrol. 2015; 30: 425-432
NICE. Guidelines: Urinary tract infection (lower): antimicrobial prescribing: National Institute for Health and Care Excellence:34
Pouladfar G, Basiratnia M, Anvarinejad M, et al. The antibiotic susceptibility patterns among the population with urinary tract infection in Shiraz. Medicine Baltimore. 2017; 96: e7834
Valerie P. O’Brien, Thomas J. Hannan, Hailyn V. Nielsen, et al. Drug and Vaccine Development for the Treatment and Prevention of Urinary Tract Infections. Microbiol Spectr. 2016.
Schito G.C., Naber K.G., Botto H., et al. The ARESC study: an international survey on the antimicrobial resistance of pathogens involved in uncomplicated urinary tract infections. Int J Antimicrob Agents 2009;34:407-13.
Сухорукова М.В., Эйдельштейн М.В., Склеенова Е.Ю. и др. Антибиотикорезистентность нозокомиальных штаммов Enterobacteriaceae в стационарах России: результаты многоцентрового эпидемиологического исследования МАРАФОН в 2011–2012 гг. // Клиническая микробиология и антимикробная химиотерапия. – 2014. – Т. 16, № 4. – С. 254–265.
Antimicrobial resistance surveillance in Europe Annual report of European Antimicrobial resistance surveillance network (EARS-net), 2011. Stockholm: ECDC; 2012. 79 p.
European Centre for Disease prevention and Control/European Medicines Agencies (ECDPC/EMA) ECDC/EMEA Joint Technical report. Stockholm: ECDPC/EMA; 2009. The bacterial challenge: time to react. A call to narrow the gap between multidrug-resistant bacteria in the EU and the development of new antibacterial agents.
Komesu Y.M., Richter H.E., Carper B. et al. Int Urogynecol J (2018) 29: 1785. https://doi.org/10.1007/s00192-018-3683-6
Будник Т.В. Антибиотикорезистентность в контексте инфекции мочевыводящих путей // Семейная медицина. – 2015. – № 4 (60). – С. 78–85.
Бондар М.В., Пилипенко М.М., Свінтуковський М.Ю. та ін. Антибіотикорезистентність мікроорганізмів: механізми розвитку й шляхи запобігання // Журнал «Медицина неотложных состояний». – 2016. – № 3 (74).
Эрман М.В. Инфекция мочевой системы у детей. Терапия и резистентность // Материалы IV Юбилейной международной конференции АО Olainfarm. – 2012. – С. 28–34.
Mike Tyers & Gerard D. Wright. 2019. Drug combinations: a strategy to extend the life of antibiotics in the 21st century. Nature Reviews Microbiology. 17, 141–155
Иванов Д.Д., Кушниренко С.В. Лечение цистита с позиций доказательной медицины // Український терапевтичний журнал. – 2009. – № 1. – С. 30–32.
Vila J, Sáez-López E, Johnson JR, Römling U, Dobrindt U, Cantón R, Giske CG, Naas T, Carattoli A, Martínez-Medina M, Bosch J, Retamar P, Rodríguez-Baño J, Baquero F, Soto SM. Escherichia coli: an old friend with new tidings. FEMS Microbiol Rev, 2016 Jul 1, 40(4): 437-463.
Буднік Т.В. Питання раціонального використання антибіотиків в лікуванні інфекції сечових шляхів та стратегія управління антибіотикорезистентністю // Семейная медицина. – 2019. – № 1 (81). – С. 1–5.
Miroslav Hanuš, Michaela Matoušková, Vlasta Králová еt al. (2015). Immunostimulation with polybacterial lysate (urivac®) in preventing recurrent lower urinary tract infections. Ces Urol. 19(1): 33–43.
Іванов Д.Д., Іванова Т.П., Федоренко О.Г та ін.. Можливості сучасної протирецидивної терапії інфекцій сечових шляхів у дітей: дослідження CRUTIL / Д.Д. Іванов, Т.П. Іванова, О.Г. Федорченко, С.В. Кушніренко, М.Д. Іванова // Почки. – 2019. – Т. 8, № 2. – С. 48–52.
Castro M., Lythe G., Molina-Paris C., Ribero R.M. Mathematics in modern immunology // Interface Focus. 2016. – Vol. 6, Issue 2. – https://doi.org/10.1098/rsfs.2015.0093
