Management of antibacterial therapy of infectious and inflammatory diseases of the urinary tract in children and regional peculiarities during the COVID-19 pandemic
Authors: Bezruk Volodymyr Volodymyrovych ,   1. Department of Pediatrics, Neonatology and Perinatology Medicine, Bukovinian State Medical University, Chernivtsi, Ukraine,   Volodymyr Volodymyrovych Bezruk, Department of Pediatrics, Neonatology and Perinatology Medicine, Bukovinian State Medical University, Chernivtsi, Ukraine. E-mail: vvladimyrbezruk@gmail.com, Shkrobanets Igor Dmytrovych ,   2. Department of Medical and Organizational Management, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine, Godovanets Oleksii Serhiiovych ,   1. Department of Pediatrics, Neonatology and Perinatology Medicine, Bukovinian State Medical University, Chernivtsi, Ukraine, Buriak Oleksandr Hryhorovych ,   1. Department of Pediatrics, Neonatology and Perinatology Medicine, Bukovinian State Medical University, Chernivtsi, Ukraine, Pervozvanska Olga Ivanivna ,   3. Department of Nephrology, Pediatric Clinical Hospital, Chernivtsi, Ukraine, Honcharuk Ludmila Mykhailivna ,   4. Department of Internal Medicine, Bukovinian State Medical University, Chernivtsi, Ukraine, Voytkevich Nina Ivanivna ,   5. Department of Foreign Languages, Bukovinian State Medical University, Chernivtsi, Ukraine, Makarova Olena Victorivna ,   6. Department of Care for Patients and Higher Nursing Education, Bukovinian State Medical University, Chernivtsi, Ukraine, Yurkiv Oksana Ivanivna ,   6. Department of Care for Patients and Higher Nursing Education, Bukovinian State Medical University, Chernivtsi, Ukraine, Sheremet Michael Ivanovych ,   7. Surgery Department No.1, Bukovinian State Medical University, Chernivtsi, Ukraine, Hresko Mykhailo Mykhailovich ,   7. Surgery Department No.1, Bukovinian State Medical University, Chernivtsi, Ukraine, Velia Mariya Ivanivna ,   8. Department of Pharmacy, Bukovinian State Medical University, Chernivtsi, Ukraine, Yurniuk Svyatoslava Vasylivna ,   8. Department of Pharmacy, Bukovinian State Medical University, Chernivtsi, Ukraine, Hresko Maryna Dmytrivna ,   9. Department of Obstetrics and Gynecology, Bukovinian State Medical University, Chernivtsi, Ukraine, Bulyk Tetiana Sergiivna ,   9. Department of Obstetrics and Gynecology, Bukovinian State Medical University, Chernivtsi, Ukraine, Rynzhuk Larysa Vasylyvna ,   9. Department of Obstetrics and Gynecology, Bukovinian State Medical University, Chernivtsi, Ukraine
Published: November 2022

Urinary tract infections (UTIs) remain an urgent issue in clinical pediatrics. Empirical selection of antibacterial therapy becomes more complicated, and antibacterial drug indication is not always clinically substantiated. This study aimed to compare the antibacterial susceptibility pattern of the main group of urinary tract infectious agents from 2009–2016 with intermediate results from 2020–2021, during the COVID-19 pandemic, among children in the Chernivtsi region. Urine samples were collected from 3089 children (0–17 years old) treated at the health care institutions in the Chernivtsi region (2009–2016). The clinical-laboratory examination of 177 children (0–17 years old) was carried out from 2020 to 2021. The children received specialized medical care at the Department of Nephrology. Preliminary data of regional monitoring (2020–2021) are not considerably different from the previous regional susceptibility of antibiotics: to penicillin (p<0.01), ІІ-ІІІ generation cephalosporin (p<0.01); an increased resistance to levofloxacin (χ2=4,338; p<0.01), tetracycline – χ2=7,277; p<0.01; doxycycline – χ2=5,309; p<0.01) and imipenem – χ2=5,594; p<0.01). The data obtained did not explain an increased resistance to fluoroquinolones completely (ofloxacin, pefloxacin, ciprofloxacin), except for levofloxacin (χ2=4,338; p<0.01). A reliable difference of susceptibility of tetracycline group was registered (tetracycline – χ2=7,277; p<0.01; doxycycline – χ2=5,309; p<0.01). Furthermore, there was a regional increase in some UTI-pathogen strains resistant to carbapenems (imipenem – χ2=5,594; p<0.01). The use of antibiotics from the group of penicillins and II-III generation cephalosporins as the starting antibacterial therapy for STIs during the COVID-19 pandemic should be justified. A regional increase (2020–2021) of some uropathogenic strains resistant to carbapenems administered to treat severe bacterial infections requires their exclusively designated purpose in everyday pediatric practical work.