Pediatrics. Consilium MedicumPediatrics. Consilium MedicumПедиатрия. Consilium Medicum2658-66302658-6622Consilium Medicum5709410.26442/26586630.2019.4.190746ArticlesСтатьиReview ArticleRATIONAL ANTIBACTERIAL THERAPY OF URINARY TRACT INFECTIONS IN CHILDREN: A NEW OPINION BASED ON ANTIBIOTIC RESISTANCE DATAРАЦИОНАЛЬНАЯ АНТИБАКТЕРИАЛЬНАЯ ТЕРАПИЯ ИНФЕКЦИИ МОЧЕВЫХ ПУТЕЙ У ДЕТЕЙ: НОВЫЙ ВЗГЛЯД С УЧЕТОМ ДАННЫХ ОБ АНТИБИОТИКОРЕЗИСТЕНТНОСТИZakharovaIrina N.ЗАХАРОВАИРИНА НИКОЛАЕВНА

д-р мед. наук, проф., зав. каф. педиатрии с курсом поликлинической педиатрии

zakharova-rmapo@yandex.ruKasjanovaAnna N.КАСЬЯНОВААННА НИКОЛАЕВНА

клин. ординатор каф. педиатрии с курсом поликлинической педиатрии

Russian Medical Academy of Continuous Professional EducationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования»151220194NO4 (2019)№4 (2019)455029122020Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://pediatria.orscience.ru/2658-6630/article/view/57094

Today, rational treatment of urinary tract infections (UTI) is an urgent task, since increasing antibiotic resistance leads to a significant decrease in its effectiveness with previously used drugs. The review provides current information on the etiological structure of UTI in children, demonstrating the results of large studies, as well as the existing data on the resistance of uropathogenic microorganism strains to modern antibiotics. Recommendations for the use of antibacterial drugs for UTI in children are also shown, including effective antibiotic regimens.

На сегодняшний день рациональная терапия инфекций мочевых путей (ИМП) является актуальной задачей, поскольку возрастающая антибиоти-корезистентность приводит к значительному снижению ее эффективности ранее применяемыми препаратами. В обзоре представлены современные сведения об этиологической структуре ИМП в детской популяции, продемонстрированы результаты крупных исследований, данные об устойчивости уропатогенных штаммов микроорганизмов к современным антибиотикам. Также показаны рекомендации по использованию антибактериальных препаратов при ИМП у детей, включая эффективные схемы применения антибиотиков.

urinary tract infectionantibioticsantibiotic resistancechildrentherapypreventionuropathogensинфекция мочевых путейантибиотикиантибиотикорезистентностьдетитерапияпрофилактикауропатогеныKocak M, Buyukkaragoz B, CelebiTayfur A et al. Causative pathogens and antibiotic resistance in children hospitalized for urinary tract infection. PediatrInt 2016; 58: 467-71.Swerkersson S, Jodal U, Ahren C, Hansson S. Urinary tract infection in small outpatient children: the influence of age and gender onresistance to oral antimicrobials. Eur J Pediatr 2014; 173: 1075-81.Garau J, Nicolau DP, Wullt B, Bassetti M. Antibiotic stewardship challenges in the management of community-acquired infections for prevention of escalating antibiotic resistance. J Glob Antimicrob Resist 2014; 2 (4): 245-53. DOI: 10.1016/j.jgar.2014.08.002Linhares I, Raposo T, Rodrigues A, Almeida A Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections: a 10-year surveillance study (2000-2009). BMC Infect Dis 2013; 13: 19.Brandstrom P, Hansson S. Long-term, low-dose prophylaxis against urinary tract infections in young children. Pediatr Nephrol 2015; 30: 425-32.Чугунова О.Л., Шумихина М.В. Инфекция мочевой системы у детей: актуальные вопросы. Эффективная фармакотерапия. 2015; 22: 10-21. @@Chugunova O.L., Shumikhina M.V. Infektsiia mochevoi sistemy u detei: aktual'nye voprosy Effektivnaia farmakoterapiia. 2015; 22: 10-21 (in Russian).Петросян Э.К., Османов И.М., Гаврилова В.А., Резников А.Ю. Противорецидивная терапия инфекции мочевых путей у детей: проблемы и пути решения. Доктор.Ру. 2010; 1 (52): 31-4. @@Petrosian E.K., Osmanov I.M., Gavrilova V.A., Reznikov A.Iu. Protivoretsidivnaia te-rapiia infektsii mochevykh putei u detei: problemy i puti resheniia. Doktor.Ru. 2010; 1 (52): 31-4 (in Russian).Delbet JD, Lorrot M, Ulinski T. An update on new antibiotic prophylaxis and treatment for urinary tract infections in children. Expert Opin Pharmacother 2017; 18 (15): 1619-25. DOI: 10.1080/14656566.2017.1383383European Comission Report, Antimicrobial Resistance 2016, http://ec.europa.eu/dgs/health_food-safety/amr/index_en.htm,last accessed May/2017Захарова И.Н., Османов И.М., Мумладзе Э.Б. и др. Инфекция мочевых путей у детей: что нужно знать педиатру и нефрологу. Мед. совет. 2015; 14: 114-8. @@Zakharova I.N., Osmanov I.M., Mumladze E.B. et al. Infektsiia mochevykh putei u detei: chto nuzhno znat' pediatru i nefrologu. Med. sovet. 2015; 14: 114-8 (in Russian).Захарова И.Н., Османов И.М., Мачнева Е.Б. и др. Лечение и профилактика инфекций мочевых путей у детей: обзор ведущих рекомендаций европейских экспертов. Педиатрия (Прил. к журн. Consilium Medicum). 2017; 1: 10-6. @@Zakharova I.N., Osmanov I.M., Machneva E.B. et al. Treatment and prevention of urinary tract infections in children: an overview of the leading recommendations of European experts. Pediatrics (Suppl. Consilium Medicum). 2017; 1: 10-6 (in Russian).Абдуллаев Р.К., Сапаев О.К., Каримов Р.О. Современный взгляд на микробный пейзаж инфекций мочевых путей у детей. Журн. теоретической и клинической медицины. 2017; 2: 87-9. @@Abdullaev R.K., Sapaev O.K., Karimov R.O. Sovremennyi vzgliad na mikrobnyi pei-zazh infektsii mochevykh putei u detei. Zhurn. teoreticheskoi i klinicheskoi medit-siny. 2017; 2: 87-9 (in Russian).Малкоч А.В., Филатова Н.Н., Дудко М.Ю., Куликова Е.Г. Инфекция мочевых путей у детей. Фарматека. 2019; 26 (1): 38-43. @@Malkoch A.V., Filatova N.N., Dudko M.Iu., Kulikova E.G. Infektsiia mochevykh putei u detei. Farmateka. 2019; 26 (1): 38-43 (in Russian).Водяник А.А., Гречуха Е.А., Понятовский В.А. и др. Резистентность к противо-микробным препаратам среди клинических изолятов, выделенных при инфекциях мочевых путей у детей. Почки. 2018; 7 (1): 26-34. @@Vodianyk AA., Grechukha Y.O., Ponyatovskiy V.A et al. Resistance of bacteria isolated in urinary tract infections to antimicrobial drugs in children. Pochki. 2018;7 (1): 26-34 (in Russian).Oteo J, Orden B, Bautista V et al. CTX-M-15-producing urinary Escherichia coli O25b-ST131 phylogroup B2 has acquired resistance to fosfomycin. J Antimicrob Chem 2009; 64 (4): 712-7. DOI: 10.1093/jac/dkp288Kutasy B, Coyle D, Fossum M. Urinary Tract Infection in Children: Management in the Era of Antibiotic Resistance-A PediatricUrologist's View. Eur Urol Focus 2017;(2-3): 207-11. DOI: 10.1016/j.euf.2017.09.013Saltoglu N, Karali R, Yemisen M et al. Comparison of community-onset healthcare-associated and hospital-acquired urinary infections caused by extended-spectrum beta-lactamase-producing Escherichia coli and antimicrobial activities. Int J Clin-Pract 2015; 69 (7): 766-70.Ladhani S, Gransden W. Increasing antibiotic resistance among urinary tract isolates. Arch Dis Child 2003; 88 (5): 444-5.Gaspari RJ, Dickson E, Karlowsky J et al. Antibiotic resistance trends in paediatricu-ropathogens. Int J Antimicrob Agents 2005; 26 (4): 267-71.Zorc JJ, Levine DA, Platt SL et al. Clinical and demographic factorsassociated with urinary tract infection in young febrile infants. Pediatrics 2005; 116 (3): 644-8.Палагин И.С., Сухорукова М.В., Дехнич А.В. и др. Современное состояние антибиотикорезистентности возбудителей внебольничных инфекций мочевых путей в России: результаты исследования «ДАРМИС» (2010-2011). Клиническая микробиология и антимикробная химиотерапия. 2012; 14 (4): 280-302.Warren JW, Abrutyn E, Hebel JR et al. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA). Clin Infect Dis 1999; 29 (4): 745-58.Allocati N, Masulli M, Alexeyev MF et al. Escherichia coli in Europe: anoverview. Int J Environ Res Public Health 2013; 10 (12): 6235-54.Clark CJ, Kennedy WA, Shortliffe LD. Urinary tract infection in children: When to worry. Urol Clin North Am 2010; 37 (2): 229-41.Jackson MA, Schutze GE; Committee On Infectious Diseases. The use of systemic and topical fluoroquinolones. Pediatrics 2016; 138 (5). pii: e20162706.Leung AKC, Wong AHC, Leung AAM, Hon KL. Urinary Tract Infection in Children. Recent Patents Inflam Allergy Drug Dis 2019; 13: 1-17.Shaikh N, Hoberman A. Urinary tract infections in infants older than one month and young children: Acute management, imaging, and prognosis. In: Post TW, ed. UpToDate. Waltham, MA.Glasner C, Albiger B, Buist G et al. Carbapenemase-producing Enterobacteriaceae in Europe: a survey among national expertsfrom 39 countries, February 2013. Euro Surveill 2013; 18 (28): 1-7.Sanchez GV, Baird AMG, Karlowsky JA et al. Nitrofurantoin retains antimicrobial activity against multidrug-resistant urinary Escherichia coli from US outpatients. J Antimicrob Chemother 2014; 69 (12): 3259-62.Konca C, Tekin M, Uckardes F et al. Antibacterial resistance patternsof pediatric community-acquired urinary infection: overview. PediatrInt2017; 59: 309-15.Parajuli NP, Maharjan P, Parajuli H et al. High rates of multidrugresistance among uropathogenic Escherichia coli in children andanalyses of ESBL producers from Nepal. Antimicrob Resist Infect Control 2017; 6: 9.Mishra MP, Sarangi R, Padhy RN. Prevalence of multidrug resistanturopathogenic bacteria in pediatric patients of a tertiary carehospital in eastern India. J Infect Public Health 2016; 9: 308-14.Catal F, Bavbek N, Bayrak O et al. Antimicrobial resistance patterns ofurinary tract pathogens and rationale for empirical therapy in Turkish children for the years 2000-2006. Int Urol Nephrol 2009; 41: 953-7.Hashemian SMR, Farhadi Z, Farhadi T Fosfomycin: the characteristics, activity, and use in critical care. Ther Clin Risk Manag 2019; 15: 525-30. DOI: 10.2147/TCRM.S199119. eCollection 2019.Pineiro Perez R, Cilleruelo Ortega MJ, Ares 3lvarez J et al; Grupo Colaborador de InfecciHn Urinaria en PediatrTa; Grupo colaborador de infecciHn urinaria en pedi-atrTa. Recommendations on the diagnosis and treatment of urinary tract infection. An Pediatr (Barc) 2019; 90 (6): 400.e1-400.e9. DOI: 10.1016/j.anpedi.2019.02.009Lutter SA, Currie ML, Mitz LB, Greenbaum LA Antibiotic resistance patterns in children hospitalized for urinary tract infections. Arch Pediatr Adolesc Med 2005; 159: 924-8.The world medicines situation 2011, http://www.who.int/medicines/areas/policy/world_medicines_situationZWMS_ch14_wRational.pdf, last accessed May/2017Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T 2015;40 (4): 277-83.Hodson EM, Willis NS, Craig JC. Antibiotics for acute pyelonephritis in children. Cochrane Database Syst Rev 2007; 4: CD00377.Strohmeier Y, Hodson EM, Willis NS et al. Antibiotics for acute pyelonephritis in children. Cochrane Database Syst Rev 2014; 7: CD003772.Leung AK. Urinary tract infection. Common problems in ambulatory pediatrics: Specific clinical problems, volume 1. New York: Nova Science Publishers, Inc., 2011; p. 173-81.Awais M, Rehman A, Baloch NU et al. Evaluation and management of recurrent urinary tract infections in children: State of the art. Expert Rev Anti Infect Ther 2015; 13 (2): 209-31.Ammenti A, Cataldi L, Chimenz R et al. Italian Society of Pediatric Nephrology. Febrile urinary tract infections in young children: Recommendations for the diagnosis, treatment and follow-up. Acta Paediatr 2012; 101 (5): 451-7.Williams GJ, Macaskill P, Chan SF et al. Absolute and relative accuracy of rapid urine tests for urinary tract infection in children: A meta-analysis. Lancet Infect Dis 2010; 10 (4): 240-50.Grabe M, Bartoletti R, Bjerklund Johansen TE et al. Guidelines on Urological Infections. European Association of Urology 2015.Robinson JL, Finlay JC, Lang ME, Bortolussi R. Urinary tract infections in infants and children: Diagnosis and management. Paediatr Child Health 2014; 19 (6): 315-25.Sedberry-Ross S, Pohl HG. Urinary tract infections in children. Curr Urol Rep 2008; 9 (2): 165-71.Baumer JH, Jones RW. Urinary tract infection in children, National Institute for Health and Clinical Excellence. Arch Dis Child Educ Pract Ed 2007; 92 (6): 189-92.Jackson MA, Schutze GE; Committee On Infectious Diseases. The use of systemic and topical fluoroquinolones. Pediatrics 2016; 138 (5). pii: e20162706.Palazzi DL, Campbell JR. Acute infectious cystitis: Management and prognosis in children older than two years and adolescents. In: Post TW, ed. UpToDate. Waltham, MA.Перепанова Т.С., Козлов РС., Дехнич А.В. и др. Выбор антимикробных препаратов при инфекции мочевыводящих путей. Урология. 2012; 2: 4-8. @@Perepanova T.S., Kozlov R.S., Dekhnich A.V. et al. Vybor antimikrobnykh preparatov pri infektsii mochevyvodiashchikh putei. Urologiia. 2012; 2: 4-8 (in Russian).Рафальский В.В. Антибиотикорезистентность возбудителей неосложненных инфекций мочевых путей в Российской Федерации. Вестн. урологии. 2018; 6 (3): 50-6. @@Rafal'skii V.V. Antibiotikorezistentnost' vozbuditelei neoslozhnennykh infektsii moc-hevykh putei v Rossiiskoi Federatsii. Vestn. urologii. 2018; 6 (3): 50-6 (in Russian).Синякова Л.А., Косова И.В. Антимикробная терапия неосложненных инфекций мочевых путей. Consilium Medicum. 2014; 16 (7): 29-33. @@Siniakova L.A., Kosova I.V. Antimikrobnaia terapiia neoslozhnennykh infektsii mochevykh putei. Consilium Medicum. 2014; 16 (7): 29-33 (in Russian).Kresken M, Korber-Irrgang B, Biedenbach DJ et al. Comparative in vitro activity of oral antimicrobial agents against Enterobacteriaceae from patients with community-acquired urinary tract infections in three European countries. Clin Microbiol Infect 2016; 22 (1): 63.e1-63.e5. DOI: 10.1016/j.cmi.2015.08.019Bocquet N, Sergent Alaoui A, Jais JP et al. Randomized trial of oral versus sequential IV/oral antibiotic for acute pyelonephritis in children. Pediatrics 2012; 129 (2): e269-75. DOI: 10.1542/peds.2011-0814Синопальников А.И., Зайцев А.А. Комплаентность антибактериальной терапии инфекций дыхательных путей. Клиническая микробиология и антимикробная химиотерапия. 2008; 10: 15-23. @@Sinopal'nikov A.I., Zaitsev A.A. Komplaentnost' antibakterial'noi terapii infektsii dykhatel'nykh putei. Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia. 2008; 10: 15-23 (in Russian).