Cephalosporins for first febrile urinary tract infection from Enterobacteriaceae with antimicrobial resistance in young children.

Febrile urinary tract infection (fUTI) due to third-generation cephalosporin (G3C)-resistant (G3CR) Enterobacteriaceae becomes a global health problem.1 The antibiotic therapy of choice for G3CR-fUTI is limited, and broad-spectrum antibiotics including carbapenems and aminoglycosides are advocated as first-line treatment. Nevertheless, data from murine pyelonephritis caused by Escherichia coli have shown that renal bacterial eradication and interleukin-6 expression after ceftriaxone administration were similar between s-lactamase-producing bacteria and non-s-lactamase-producing bacteria.