Does taking 2 antibiotics cause resistance in 20 month old?

Question

Hello doctor,

My son, who is aged 20 months, has been identified with a urine infection with the following antibiotics, as he is sensitive to antibiotics like Colistin sulfate, Polymyxin B, and Fosfomycin.The doctor has prescribed the following antibiotics for 14 days through IV: Gigabac (2.25 lac every 8 hours) and Fosamax (900 mg every 8 hours). He had previously had nephrostomy surgery for hydronephrosis. His nephrostomy tube has been inserted for over 2.5 months. Urine is still passing through the tube. The doctor suggested a second procedure after completing the antibiotic treatment mentioned above. His creatinine level before beginning the antibiotic course was 0.15 mg/dL. The question I have is:

Is it possible to continue two antibiotic courses simultaneously despite the danger of antibiotic resistance?
Is it okay to continue for seven days if the urine culture report is normal?
What are the potential hazards of injecting two antibiotics?
When is the appropriate time to perform the second surgery?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Administering two antibiotics simultaneously is often feasible and sometimes necessary to cover a broad spectrum of bacteria or to address severe infections.Continuing antibiotics for a full fourteen days is usually recommended to ensure complete eradication of the infection, especially in the presence of a urinary catheter or nephrostomy tube.

If the urine culture report is clear after seven days, the doctor may reassess the necessity of continuing both antibiotics or potentially reducing the duration, but this decision should be made based on clinical judgment.

The main risks include potential side effects like allergic reactions, kidney toxicity (nephrotoxicity describes the process that occurs when kidneys are damaged by a drug, chemical, or toxin, resulting in possible chronic kidney disease), gastrointestinal disturbances (gastrointestinal diseases refer to diseases involving the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine, and rectum), and antibiotic resistance (occurs when bacteria change so that antibiotic medicines cannot kill them or stop their growth).

Monitoring kidney function (creatinine levels, etc.) and other vital signs throughout the treatment is essential to mitigate these risks.The second surgery should be scheduled after completing the antibiotic course and ensuring that any active infection is fully resolved. This is to minimize the risk of complications during surgery.The exact timing should be decided based on the patient’s overall condition and response to antibiotics.

I hope this helps.

Kindly revert in case of further queries.

Thank you.