What is the Appropriate Empiric Antibiotic Therapy in Uncomplicated Urinary Tract Infections in Children in Developing Countries?
The WHO Pocketbook of Hospital Care for Children recommends for antibiotic therapy • Give oral cotrimoxazole (4 mg trimethoprim/20 mg sulfamethoxazole per kg every 12 h) for 5 days. Alternatives include ampicillin, amoxicillin and cephalexin, depending on local sensitivity patterns of Escherichia coli and other Gram-negative bacilli that cause UTI, and on antibiotic availability (see page 325 for details of dosage regimens). • If there is a poor response to the first-line antibiotic or the child’s condition deteriorates, give gentamicin (7.5 mg kg 1 IM once daily) plus ampicillin (50 mg kg 1 IM/IV every 6 h) or a parenteral cephalosporin (see pages 330 331). Consider complications such as pyelonephritis (tenderness in the costo-vertebral angle and high fever) or septicaemia. • Treat young infants aged <2 months with gentamicin (7.5 mg kg 1 IM once daily) until the fever has subsided; then review, look for signs of systemic infection, and if absent, continue with oral treatment, as desc
