Villeneuve Les Avignon

The emergence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (E-ESBL) is an important public health concern, especially in children with urinary tract infections (UTIs). These bacteria can lead to increased use of penem antibiotics, which may cause resistant strains. This study evaluates the effects of different antibiotic treatments on the presence of E-ESBL in the digestive tract of children aged 3 months to under 3 years who have febrile UTIs. The goal is to compare the impact of intravenous amikacin versus intravenous or intramuscular ceftriaxone or oral cefixime on the emergence of these bacteria in stools. Participants receive one of the antibiotic treatments as monotherapy: amikacin given intravenously, ceftriaxone administered either intravenously or intramuscularly, or cefixime taken orally. Before starting treatment, an anorectal swab is collected to check for E-ESBL bacteria, and a second swab is taken three to four days after beginning the antibiotic therapy to monitor any changes. During the study, children are monitored for the presence of E-ESBL in their stools on day 4 through these swabs. Parents provide consent and confirm their understanding of the study information. The study measures the bacterial carriage in the digestive tract after treatment and ensures safety by excluding children currently hospitalized or on multiple antibiotics. The participation duration aligns with the timing of these assessments.