Efficacy and tolerability of long-term oral cefaclor therapy in the prevention of urinary tract infections in infants and children

The efficacy and tolerability of long-term therapy with oral cefaclor 25 mg/kg per day administered in the evening was assessed in 30 infants and children with recurrent urinary tract infections (UTIs) most of which were associated with structural and functional abnormalities of the urinary tract. After 8 days of therapy, all organisms were eradicated with cefaclor, and patients who were symptomatic improved. Seventeen patients concluded 6 months of treatment with cefaclor. Urinary concentrations of cefaclor in these patients remained higher than the minimum inhibitory concentration needed to eradicate 90% of the bacteria responsible for UTIs. Six of these 17 patients continued antibiotic therapy for an additional 6 months and completed this second period of cefaclor therapy with neither recurrences nor side effects. Of the 13 patients who did not complete the 6-month study, 3 suffered reinfections. Cefaclor was well tolerated, with none of the patients experiencing side effects. Similarly, no changes were noted in serum creatinine, ions, or blood analyses. Cefaclor may be a good alternative to the usual antibacterial agents used in the prevention and cure of UTIs in children.