Antibiotic-Associated Diarrhea in 3 to 6 Month Old Infants with Febrile Urinary Tract Infections

Chong Bock Won; Min Chae Kim; Byung Wook Eun; Yong Han Sun; Kang Ho Cho; Hann Tcha; In Sang Jeon

doi:10.14776/kjpid.2012.19.1.12

Journal List > Korean J Pediatr Infect Dis > v.19(1) > 1096059

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Won, Kim, Eun, Sun, Cho, Tcha, and Jeon: Antibiotic-Associated Diarrhea in 3 to 6 Month Old Infants with Febrile Urinary Tract Infections

Original Article

Korean Journal of Pediatric Infectious Diseases

Korean Journal of Pediatric Infectious Diseases 2012; 19(1): 12-18.

Published online: 30 April 2012

DOI: https://doi.org/10.14776/kjpid.2012.19.1.12

Antibiotic-Associated Diarrhea in 3 to 6 Month Old Infants with Febrile Urinary Tract Infections

Chong Bock Won, M.D., Min Chae Kim^*, Byung Wook Eun, M.D., Yong Han Sun, M.D., Kang Ho Cho, M.D., Hann Tcha, M.D., In Sang Jeon, M.D.

Department of Pediatrics, Gachon University Gil Hospital, Incheon, Korea.

^*Graduate School of Medicine, Gachon University, Incheon, Korea.

Corresponding author (acet0125@gilhospital.com)

Received 16 September 2011 Revised 19 October 2011 Accepted 20 October 2011

Abstract

Purpose

This study attempted to investigate the frequency, duration, and risk factors of antibiotic-associated diarrhea (AAD) in infants hospitalized due to febrile urinary tract infection (UTI). This is a basic research on the probiotics used in the prevention and treatment of AAD in infants.

Methods

Medical records of the infants aged 3-6 months hospitalized in Gachon University Gil Hospital from January 2008 to September 2010 due to the febrile UTI were retrospectively reviewed. The episodes of loose or watery stool were investigated for frequency, onset, and duration. Those who had AAD and those who did not (non-AAD) were compared. The antibiotic regimens and the episodes of diarrhea were investigated in AAD group.

Results

Total 147 infants were included. Fifty-four (36.7%) showed AAD. Intravenous third-generation cephalosporin (3^rd CS) single therapy was used for 102 patients (69.4%), the 3^rd CS and non-3^rd CS combination therapy for 24 (16.3%), and non-3^rd CS combination therapy for 21 (14.3%). There was no significant difference in the dose of cefotaxime between AAD and non-AAD group (P=0.601). According to the antibiotic therapies above, in AAD group, there was no significant difference in the onset and duration of diarrhea respectively (P=0.717, P=0.830). Although the frequency of diarrhea was higher for the 3^rd CS and non-3^rd CS combination therapy subgroup with 9.25±5.30 times/day than the other two subgroups (7.58±2.97 times/day in 3^rd CS single therapy subgroup, 6.75±4.40 times/day in non-3^rd CS combination therapy subgroup), there was no statistical significance (P=0.078).

Conclusion

AAD seems common to the infants aged 3-6 months with febrile UTI, regardless of regimen and amount of antibiotics in usual dosage. Further research on the effects of probiotics used in the prevention and treatment of AAD in infants is warranted.

Keywords: Urinary tract infection, Diarrhea, Antibiotics, Child

Figures and Tables

Table 1

Comparisons between Antibiotic-associated Diarrhea Group and Non-antibiotic-associated Diarrhea Group

^*mean±SD

^†AAD=Antibiotic-associated diarrhea

^‡Non-AAD=Non Antibiotic-associated diarrhea

^∫n=34 in AAD group, n=51 in non-AAD group

^¶Etc.=Proteus mirabilis, Citrobacter koseri, Streptococcus agalactiae, Klebsilella oxytoca, Serratia marcescens, Citrobacter freundii, other G (+) cocci, other G (−) rod

^**n=32 in AAD group, n=65 in non-AAD group

^††spp.=species

Table 2

Comparisons Between Antibiotic Regimens in Antibiotic-associated Diarrhea Group

^*mean±SD

^†3rd CS=third generation cephalosporin

^‡Non-3rd CS=Non-third generation cephalosporin

^¶Diarrhea onset=interval between start of intravenous antibiotics use and occurrence of diarrhea

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