Pediatric Escherichia Coli Infections Medication

Updated: Mar 19, 2019
  • Author: Archana Chatterjee, MD, PhD; Chief Editor: Russell W Steele, MD  more...
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Medication

Medication Summary

Antibiotic therapy is not indicated in most cases of Escherichia coli enteritis; guidelines for specific circumstances are outlined below.

Antimotility agents are contraindicated for all cases of pediatric gastroenteritis.

Urinary tract infections (UTIs) may be treated with various oral antibiotics, most commonly trimethoprim and sulfamethoxazole, amoxicillin, or cefixime. Duration of therapy is 10 days.

Neonatal sepsis and meningitis are treated based on identified organism susceptibility and clinical response.

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Antibiotics

Class Summary

Treatment of traveler's diarrhea is rarely necessary. Prophylaxis for traveler's diarrhea with medications (eg, bismuth subsalicylate, trimethoprim and sulfamethoxazole) is not recommended for children because of potential salicylate accumulation and allergic reactions. Efficacy of antibiotic treatment of enteroinvasive E coli (EIEC) and enterohemorrhagic E coli (EHEC) is not established. Data suggest treating EHEC does not alter the course of infection and increases risk of subsequent hemolytic-uremic syndrome (HUS). UTI in infants and children is treated for 10 days because of the difficulty distinguishing between uncomplicated cystitis and pyelonephritis.

Sulfamethoxazole and Trimethoprim (Bactrim, Cotrim, Septra)

First-line therapy for UTI and most E coli diarrheal illness; resistant organisms are fairly common.

Amoxicillin (Amoxil, Biomox, Trimox)

Reasonable choice to treat pediatric UTI. Liquid preparation is palatable and well tolerated. It is concentrated in the urine and active against most gram-positive and some gram-negative organisms.

Cefixime (Suprax)

Third-generation cephalosporin is a second-line choice to treat UTI or traveler's diarrhea; liquid preparation is pleasant tasting.

Ampicillin (Marcillin, Omnipen, Polycillin, Principen, Totacillin)

Administer parenterally in combination with an aminoglycoside or cephalosporin in cases of neonatal sepsis or meningitis; PO preparation is a second-line therapy for traveler's diarrhea and dysentery.

Gentamicin

Aminoglycoside antibiotic used in combination with ampicillin to treat neonatal sepsis and meningitis; provides gram-negative coverage and works synergistically against gram-positives.

Cefotaxime (Claforan)

Third-generation cephalosporin administered parenterally in combination with ampicillin to treat neonatal sepsis or meningitis.

Ciprofloxacin (Cipro, Ciloxan)

Quinolone antibiotics are an alternative therapy for adult UTI or bacterial enteritis. Use is contraindicated in pediatric patients when an acceptable alternative is available.

Rifaximin (Xifaxan, RedActiv, Flonorm)

Nonabsorbed (< 0.4%), broad-spectrum antibiotic specific for enteric pathogens of the GI tract (ie, gram-positive, gram-negative, aerobic and anaerobic). Rifampin structural analog. Binds to beta-subunit of bacterial DNA-dependent RNA polymerase, thereby inhibiting RNA synthesis. Indicated for E coli (enterotoxigenic and enteroaggregative strains) associated with traveler's diarrhea.

Ceftazidime/avibactam (Avycaz)

Indicated for adults and pediatric patients aged 3 months or older for complicated intra-abdominal infections (cIAIs) in combination with metronidazole and for complicated urinary tract infections (cUTIs) including pyelonephritis caused by certain susceptible Gram-negative microorganisms, including Escherichia coli.

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