cefdinir and Escherichia-coli-Infections

This study evaluated the effect of prophylactic cefdinir (3 mg/kg given once daily) for the prevention of recurrent and complicated urinary tract infections (UTI) in pediatric patients.. The study included 14 infants who were observed for at least 6 months following the first signs of infection (eight boys, six girls; mean age at admission [± SD]: 6.2 [± 7.4] months). Twelve patients had vesico-ureteric reflux (grade I, two; grade II, three; grade III, six; grade IV, one), and two patients had ureteropelvic junction stenosis.. No patients discontinued medication due to diarrhea or other adverse drug reactions. The patients had a 6-month recurrence-free rate of 93% (13/14); only one patient had recurrent UTI. The mean urinary cefdinir concentration was 16.3 [± 11.7]µg/mL; there was considerable variability among individual measurements, even though the samples were collected at similar intervals after drug intake (mean 18.00 [± 2.63] h after dose). However, the lowest measured urinary cefdinir concentration (1.16 µg/mL) was sufficient to eradicate Escherichia coli, one of the most significant causes of UTI. Fecal cultures, obtained at monthly clinic visits during the observation period, indicated that the patients' E. coli strains were very sensitive to cefdinir. No patients were infected with Pseudomonas aeruginosa or other non-fermenting Gram-negative bacilli or fungi.. These results show that cefdinir given 3 mg/kg once daily is very effective and safe for preventing recurrent complicated UTI in infants.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefdinir; Cephalosporins; Cohort Studies; Drug Administration Schedule; Enterococcus faecalis; Escherichia coli Infections; Female; Gram-Positive Bacterial Infections; Humans; Infant; Male; Secondary Prevention; Treatment Outcome; Urinary Tract Infections

Ciprofloxacin-resistant Escherichia coli isolates (n = 1,858) from outpatient midstream urine specimens at 40 North American clinical laboratories in 2004 to 2005 were frequently resistant to ampicillin (79.8% of isolates) and trimethoprim-sulfamethoxazole (66.5%); concurrent resistance to cefdinir (9.0%) or nitrofurantoin (4.0%) was less common. Only 10.8% of isolates were resistant to ciprofloxacin alone. Fluoroquinolone-resistant isolates of E. coli from urine were frequently multidrug resistant.

Topics: Adolescent; Adult; Ampicillin; Anti-Infective Agents, Urinary; Cefdinir; Cephalosporins; Ciprofloxacin; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Escherichia coli; Escherichia coli Infections; Female; Fluoroquinolones; Humans; In Vitro Techniques; Male; Microbial Sensitivity Tests; Middle Aged; Nitrofurantoin; North America; Outpatients; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

We tested antimicrobial activities of ten oral antibiotics; ampicillin (ABPC), cefdinir (CFDN), cefaclor (CCL), fosfomycin (FOM), norfloxacin (NFLX), nalidixic acid (NA), kanamycin (KM), minocycline (MINO), doxycycline (DOXY), and tetracycline (TC) against eleven enterohemorrhagic Esherichia coli (EHEC) O157 clinical strains. Two strains were resistant to ABPC and TC. Other strains were sensitive to all the ten antibiotics. To investigate the effect of antibiotics on extracellular release of verotoxin (VT), strain EHEC TT10 was grown in 10 ml of LB containing various concentrations of the antibiotics for 2 h. Number of viable cells were counted and the amounts of VT1 and VT2 released in the supernatants were measured with reverse passive latex agglutination (RPLA) using serially diluted sterilized culture supernatants. The amount of VT1 and VT2 was evidently increased with ABPC, CFDN, CCL, and FOM, the inhibitors of cell wall biosynthesis. In the case of quinolons, VT2 was markedly increased, but VT1 was not released to the supernatant. KM killed the bacteria efficiently, but no release of VT1 or VT2 was observed in the supernatant. Tetracyclines (MINO, DOXY, and TC) did not make the bacteria release either VT1 or VT2, but could not kill the bacteria appreciably. These results indicated that the inhibitors of protein synthesis (KM, MINO, DOXY, TC) are the safe antibiotics not causing the release of verotoxin from the cells and thus preventing development of hemolytic uremic syndrome (HUS) or thrombotic thrombocytopenic purpra (TTP), the important sequelae of the enteritis.

Topics: Ampicillin Resistance; Anti-Bacterial Agents; Bacterial Toxins; Cefdinir; Cephalosporins; Drug Resistance, Microbial; Enteritis; Escherichia coli Infections; Escherichia coli O157; Hemolytic-Uremic Syndrome; Humans; Kanamycin Resistance; Purpura, Thrombotic Thrombocytopenic; Shiga Toxin 1