Fosfomycin prophylaxis can reduce the risk of severe recurrent urinary tract infections requiring hospitalisation in children with complex urinary tract malformations
Bibliographic record
Abstract
Introduction Urinary tract infections (UTIs) with resistant bacterial strains are one of the most troublesome problems in children with severe congenital anomalies of the kidney and urinary tract (CAKUT). We present the results of non-standard prophylactic treatment with fosfomycin of infants with complex urinary tract malformations. Material and methods It was a retrospective analysis of data of 5 male infants after urological interventions due to complex CAKUT. The frequency of UTIs, their aetiology and course, frequency and duration of hospitalisation due to UTIs, prophylaxis and treatment outcomes were analysed. Results The mean follow-up period was 16 months. Mean number of UTIs during observation was 5 (2–6). Infections with multi-drug resistant strains were observed in all patients before commencing fosfomycin prophylaxis, on average 21 days after urological procedure. Due to recurrent UTIs with highly resistant or reduced susceptibility strains, despite standard prophylaxis, we introduced fosfomycin in 50–70 mg/kg dose once a day for 4–9 months what reduced frequency of infections (3.6 vs. 1.0, p = 0.01), infections with decreased susceptibility strains (3.6 vs. 0.0, p = 0.00006) and need for hospitalisations (3.6 vs. 0.2, p = 0.003). Fosfomycin was introduced after 2–5 UTIs, at the mean age of 7 months, after mean of 4 months of ineffective standard prophylaxis. We didn’t record any significant adverse effects of the treatment or bacterial resistance development. Conclusions In children with urinary tract malformations, and in particular with a history of urological interventions, in the case of recurrent UTIs with strains of reduced susceptibility to antibiotics, several months of non-standard prophylactic treatment with fosfomycin may be considered.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".