KHẢO SÁT CÁC YẾU TỐ LIÊN QUAN ĐẾN THẤT BẠI ĐIỀU TRỊ KHÁNG SINH BAN ĐẦU THEO KINH NGHIỆM Ở TRẺ EM NHIỄM TRÙNG TIỂU NHẬP VIỆN TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ

Abstract

Background: Urinary tract infection is one of the most common bacterial infections in children. Timely diagnosis and appropriate treatment, along with the identification of factors associated with failure of empirical initial antimicrobial therapy, play an important role in reducing complications and preventing recurrence. Objectives: 1. to describe the clinical and paraclinical characteristics of children aged 2 months to 16 years with urinary tract infection at Can Tho Children’s Hospital; 2. to evaluate treatment outcomes and investigate factors associated with failure of empirical initial antibiotic therapy in the study population. Materials and methods: A descriptive cross-sectional study was conducted on 70 children aged 2 months to 16 years who were hospitalized at Can Tho Children’s Hospital between 2024 and 2026. Results: Females predominated, accounting for 58.6% (female-to-male ratio: 1.4:1), and children aged ≥5 years represented the majority (61.4%). Acute cystitis was more prevalent (74%) than acute pyelonephritis (26%). The most common clinical manifestations were dysuria (72.9%) and frequency (61.4%). Positive urine culture and real-time polymerase chain reaction results were obtained in 68.6% and 97.1% of cases, respectively. The failure rateof empirical initial antimicrobial therapy was 62.9%. A prior history of urinary tract infection and previous antibiotic exposure were identified as independent risk factors associated with treatment failure (p<0.05). Conclusion: The failure rate of empirical initial antimicrobial therapy remains high. Rational use of antimicrobial agents, reduction of unnecessary antibiotic exposure, enhancement of health education, and early identification of risk factors are essential measures to improve treatment effectiveness and long-term outcomes.