Monday, April 25, 2016

Antibiotic Resistance Common in Kids’ Urinary Tract Infections

Many kids who develop urinary tract infections tied to the E. coli bacteria are now failing to respond to antibiotic treatment, a new review warns.

The culprit, according to the British researchers: Drug resistance, following years of over-prescribing and misusing antibiotics.

“Antimicrobial resistance is an internationally recognized threat to health,” noted study author Ashley Bryce, a doctoral fellow at the Center for Academic Primary Care at the University of Bristol in the U.K.

And that threat is of particular concern among young patients, the authors said, given that E. coli-driven urinary tract infections (UTIs) are one of the most common forms of pediatric bacterial infections.

Young children are more vulnerable to complications including kidney scarring and kidney failure, so they require prompt, appropriate treatment, added Bryce and co-author Caire Costelloe. Costelloe is a fellow in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, also in the U.K.

“Bacterial infections resistant to antibiotics can limit the availability of effective treatment options,” ultimately doubling a patient’s risk of death, they noted.

The findings are published in the March 15 issue of BMJ.

The study team reviewed 58 prior investigations conducted in 26 countries that collectively looked at more than 77,000 E. coli samples.

Across industrialized nations, 53% of the pediatric UTI cases were found to be resistant to amoxicillin, one of the most often prescribed primary care antibiotics.

Nearly a quarter of young patients in industrialized nations were resistant to the antibiotic trimethoprim. More than 8% were resistant to Augmentin.

“If left unaddressed, antibiotic resistance could re-create a world in which invasive surgeries are impossible and people routinely die from simple bacterial infections,” they added.

Preventing such a scenario is a “global responsibility” said Grant Russell, head of the School of Primary Health Care at Monash University in Melbourne, Australia, with the goal being to rain in the use and abuse of antibiotics. He wrote an accompanying editorial to the study.

My Take:
Antibiotic overuse and abuse has been discussed in medical circles for years. Despite all the publicity, I see little evidence that anything has changed. Now we are beginning to see the effects in children which means that pediatricians world-wide are still overprescribing antibiotics.

I treat chronic kidney disease with nutritional support. Most of my patients that suffer from this condition are elderly, diabetic, or both. However, as a reviewed this study I recognized a trend in my office toward younger patients with reduced kidney function on laboratory testing.

I had assumed that trend was related to the dramatic rise in pre-diabetes and diabetes in this country. I still believe that is the major driving force, but this research gives me pause.

The Bottom Line:
Please refrain from using antibiotics for every cough and sniffle. Give you body nutritional support during the infection and five days for the immune system to respond. If you are not improving, then seek medical help. I know it not convenient, but do the same for your children. Their lives (and the rest of our lives) may depend on it.

Source: March 16, 2016 National Institutes of Health

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