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Many children experience at least one urinary tract infection (UTI). Acute pyelonephritis is the severe presentation of a UTI with systemic features. It is associated with an increased risk of septic shock and bacteraemia, particularly among infants. This systematic review aimed to provide the best current evidence for choosing antibiotic therapy for acute pyelonephritis in children. Several aspects of therapy were considered including different: antibiotics, dosing regimens of the same antibiotic, treatment duration and routes of administration.
This updated Cochrane review included studies that assessed antibiotic therapy for bacterially proven UTI with acute pyelonephritis in children (<18 years of age). Studies including patients with previously diagnosed UTI or urinary tract abnormalities were considered eligible.
Predetermined short-term outcomes were fever duration, persistent symptoms or inflammatory markers at …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.