Pielonefrite acuta nel lattante: eziologia e sensibilità agli antibiotici

Acute pyelonephritis (APN) involves a risk of irreversible renal injury. There is no consensus on which therapy is most effective. In this study, we evaluated 108 infants aged 0-18 months, enrolled from 1/5/98 to 31/1/03, for APN. 35 patients (37%) had vesicoureteral reflux (VUR). The etiological agent was Escherichia coli in 94% of cases. Of all antibiotic tested, E. coli was sensitive to amoxicillin in 71% of cases, to amoxicillin-clavulanic acid in 79%, to cefaclor in 78%, to cefpodoxime in 100%, to ceftazidime in 100%, to cotrimoxazole in 82%, to ciprofloxacin in 97%, to ceftriaxone in 99%, to gentamycin in 100%, to nitrofurantoin in 100%. Third generation cephalosporin and aminoglycoside are first line antibiotics for APN, while resistance to amoxicillin-clavulanic acid are increasing (21% of cases). Treatment of APN must be chosen on the basis of local antibiotic resistance patterns.