Original articlesShort-course versus conventional length antimicrobial therapy for uncomplicated lower urinary tract infections in children: A meta-analysis of 1279 patients☆
Section snippets
Study Identification
An online search of the MEDLINE database covering the period of 1966 to 1999 was performed with the following Medical Subject Headings, key words, and text words: “Urinary tract infection” and “antibiotic course.” The following filters were applied: English language, human research, all children (0 to 18 years), and randomized controlled trials. The bibliography of each article was searched by hand for additional relevant studies.
Study Selection and Data Abstraction
Studies were selected by a protocol established in advance of the
Study Identification and Selection
The literature search yielded 517 citations: 505 from MEDLINE and 12 from the reference lists of retrieved articles. Studies were excluded if the designs were nonexperimental, evaluated adult patients, were in languages other than English, or compared 2 different antibiotics for the same length of treatment. Review articles were also excluded. After the titles and abstracts of each citation were examined, 37 studies were selected as potentially relevant. Of the 37 studies selected, 15 failed to
DISCUSSION
Short-course antimicrobial therapy for lower urinary tract infections is the standard of care for adults.1, 43, 44 The option of using such a regimen in children with uncomplicated lower urinary tract infections is appealing because it provides the shortest, cheapest, and safest treatment. A large number of randomized double-blinded studies comparing single-dose/short-course treatment with conventional treatment (5 days or more of antibiotics) have been completed in children. Most of these
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Urinary Tract Infection in Children
2022, Pediatric Clinics of North AmericaCitation Excerpt :There is consensus in most guidelines on treating febrile UTIs for 10 days, with a span from 7 days to up to 14 days when treating the more severely ill child with a suspected or manifest septicemia (see Table 1). For cystitis in children above 2 to 3 years of age, where kidney involvement can be ruled out, most guidelines recommend 5 days of antibiotics, with some studies supporting an even shorter 3 days course.37,38 There have been attempts to decrease the risk of kidney scarring by adding steroids to the treatment of UTI, but the results have been disappointing39,40
Evaluation and management of urinary tract infections in the school-aged child
2015, Primary Care - Clinics in Office PracticeInfectious urinary pathology
2013, FMC Formacion Medica Continuada en Atencion PrimariaMeta-analyses on Pediatric Infections and Vaccines
2009, Infectious Disease Clinics of North AmericaCitation Excerpt :Antibiotic therapy is also frequently used for lower UTIs, like cystitis and urethritis, and shorter treatment regimens seem to be adequate for these infections. Three different meta-analyses examined the efficacy of short antibiotic regimens for lower UTIs in children, and each reached a different conclusion by either refuting92 or confirming their value for all93 or for specific (TMP-SMX) antibiotics alone.94 Finally, the administration of long-term prophylactic antibiotics to prevent recurrent UTIs in children with reflux or other predisposing conditions, a very common practice, awaits further evidence to support its use.95
Meta-analyses in Prevention and Treatment of Urinary Tract Infections
2009, Infectious Disease Clinics of North AmericaCitation Excerpt :Nitrofurantoin was three times more likely to be discontinued because of the side effects of nausea, vomiting, or stomachache. The authors identified four systematic reviews that investigated antibiotic class, duration of therapy, and route of antibiotic administration in the treatment of UTI in children (see Table 3).11–14 One systematic review included a meta-analysis of six RCTs enrolling 523 children aged 2 weeks to 16 years who had a diagnosis of microbiologically proven UTI and clinical acute pyelonephritis.11
CYSTITIS AND PYELONEPHRITIS
2009, Feigin and Cherry's Textbook of Pediatric Infectious Diseases, Sixth Edition
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Reprint requests: Stephen C. Aronoff, MD, Department of Pediatrics, Temple University Children’s Medical Center, 3509 N Broad St, Philadelphia, PA 19140.