Urinary tract infections (UTIs) are common in both adults and children, and they can be caused by a variety of bacteria. In some cases, UTIs can be complicated by factors such as anatomical abnormalities, obstruction, or antibiotic-resistant bacteria, which can make them more difficult to treat. One promising treatment for complicated UTIs in children is ceftolozane/tazobactam, a combination of a cephalosporin antibiotic and a beta-lactamase inhibitor.
Clinical Trial
A clinical trial compared the safety and efficacy of ceftolozane/tazobactam with that of meropenem, another antibiotic commonly used to treat complicated UTIs. The trial included 95 pediatric patients from birth to under 18 years of age who had been diagnosed with a complicated UTI, including pyelonephritis (infection of the kidneys).
The study found that ceftolozane/tazobactam had a favorable safety profile, with rates of adverse events similar to those of meropenem. Specifically, 59% of patients in the ceftolozane/tazobactam group experienced adverse events, compared to 61% in the meropenem group. Additionally, rates of drug-related adverse events were 14% for ceftolozane/tazobactam and 15% for meropenem, and rates of serious adverse events were 3% for ceftolozane/tazobactam and 6% for meropenem.
Importantly, the study also found that ceftolozane/tazobactam was highly effective in treating complicated UTIs in children, with rates of clinical cure and microbiologic eradication similar to those of meropenem. After treatment ended, 94% of patients who took ceftolozane/tazobactam and 100% of patients who took meropenem were cured of their infection. At a later check-up called the "test-of-cure" visit, 89% of patients who took ceftolozane/tazobactam and 96% of patients who took meropenem were cured of their infection. Microbiologic eradication rates were 93% for ceftolozane/tazobactam and 96% for meropenem at the end of treatment, and 85% and 88%, respectively, at the test-of-cure visit.
The most common diagnosis in the study was pyelonephritis, and the most common pathogen was Escherichia coli. A small percentage of E. coli isolates were found to be extended-spectrum beta-lactamase (ESBL) producers, which means they are resistant to many types of antibiotics. However, the study found that ceftolozane/tazobactam was effective against these ESBL-producing bacteria, with similar rates of microbiologic response as for non-ESBL-producing bacteria.
Conclusion:
The results of this clinical trial suggest that ceftolozane/tazobactam is a safe and effective new treatment option for children with complicated UTIs, including pyelonephritis and infections caused by antibiotic-resistant Gram-negative bacteria. While further studies are needed to confirm these findings, the results are promising and suggest that this treatment could be an important addition to the pediatric antibiotic arsenal.
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