Single-dose cefotaxime in the treatment of urinary tract infections in children: a randomized clinical trial

Thirty-seven patients with a median age of 5 years with symptomatic lower or upper urinary tract infection, documented by a clean-catch midstream urine culture and sediment examination, completed a randomized study comparing the effectiveness of a single dose of cefotaxime with 10-day treatment with an antibiotic chosen by in-vitro sensitivities. Eighteen patients were randomly assigned to the cefotaxime group (50 mg/kg/im route) and 19 patients were placed in the 10-day therapy group. In the cefotaxime group 4/18 patients had an upper urinary tract infection and 11/18 had a history of recurrences. The causal organisms were Escherichia coli (16 cases) and Klebsiella pneumoniae (two cases). All patients had sterile urine 48 hours after therapy, and 2/18 cases had recurred 28 days later. In the 10-day treatment group, 7/19 patients had an upper urinary tract infection, 6/19 had a history of recurrences, 17 cases were caused by E. coli, one case by Citrobacter freundii and one case by K. pneumoniae. Eighteen of 19 patients had sterile urine 48 hours after therapy and 1 case remained symptomatic with positive culture. The other 18 patients had no recurrences. Rates of cures and recurrence in the compared groups were not statistically different (P greater than 0.05).