{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:50:38Z","timestamp":1784206238778,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T00:00:00Z","timestamp":1560211200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pyelonephritis caused by extended\u2010spectrum \u03b2\u2010lactamase (<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>)\u2010producing Enterobacteriaceae is an urgent problem in pediatrics. Although carbapenem is the standard therapy for infections caused by <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing Enterobacteriaceae, some cephamycins, including cefmetazole, are stable against hydrolysis by <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>. There are few reports, however, on the use of cefmetazole in children. The aim of this study was to evaluate the therapeutic effect of cefmetazole in pediatric pyelonephritis caused by <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing Enterobacteriaceae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children with pyelonephritis caused by <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing Enterobacteriaceae were enrolled between April 2010 and November 2016 at Tokyo Metropolitan Children's Medical Center. Presence of <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content> was tested for using the disk diffusion method. Medical records were reviewed for a past history of bacterial infection. The outcomes were clinical cure rate at 4\u00a0weeks and the duration of therapy in the cefmetazole and non\u2010cefmetazole groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010five patients met the criteria for pyelonephritis caused by <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing Enterobacteriaceae. The most common causative organisms were <jats:italic>Escherichia coli<\/jats:italic> (<jats:italic>n<\/jats:italic>\u00a0=\u00a051; 92.7%), <jats:italic>Klebsiella pneumoniae<\/jats:italic> (<jats:italic>n<\/jats:italic>\u00a0=\u00a03; 5.5%), and <jats:italic>K.\u00a0oxytoca<\/jats:italic> (<jats:italic>n<\/jats:italic>\u00a0=\u00a01; 1.8%). Thirty\u2010six and 19 patients were treated with cefmetazole and with other antibiotics as definitive therapy, respectively. There was no difference in the clinical cure rate (86.1% vs 89.5%; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.72) or duration of therapy (median, 7.0 vs 7.0\u00a0days; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.73) between the cefmetazole and non\u2010cefmetazole groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cefmetazole was not inferior to the other antibiotics in the treatment of pyelonephritis caused by <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing Enterobacteriaceae in children. Cefmetazole is a valuable therapeutic alternative to carbapenems for treating pyelonephritis caused by <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing Enterobacteriaceae.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13847","type":"journal-article","created":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T19:35:13Z","timestamp":1553542513000},"page":"572-577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cefmetazole for extended\u2010spectrum \u03b2\u2010lactamase\u2010producing Enterobacteriaceae in pediatric pyelonephritis"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6533-7857","authenticated-orcid":false,"given":"Kotaro","family":"Araki","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kahoru","family":"Fukuoka","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Division of Microbiology Department of Laboratory Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Aizawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Niigata University Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5875-1024","authenticated-orcid":false,"given":"Yuho","family":"Horikoshi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.WHO Publishes List of Bacteria for Which New Antibiotics are Urgently Needed. 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