Comparison between Short Therapy and Standard Therapy in Pediatric Patients Hospitalized with Urinary Tract Infection: A Single Center Retrospective Analysis

Abstract

Introduction: There is marked heterogeneity in clinicians’ choice of antibiotic duration for pediatric urinary tract infections (UTIs). Most patients with bacterial UTIs still receive between 7 and 10 days of antibiotics. Prolonged antibiotic exposure drives the emergence of resistance and increases the occurrence of adverse effects. There is increasing evidence that shorter antibiotic regimens may be equally effective compared with longer ones. However, studies evaluating shorter therapies in children hospitalized with urinary tract infections have not yet been performed. Methods: We performed a retrospective study comparing children hospitalized with UTIs treated with a short antibiotic (<7 days) or standard antibiotic treatment. The primary aim of our study was to assess the efficacy of a shorter antibiotic therapy for children with UTIs, compared with an historical group of children treated with a standard 7–14 days course. Results: 112 patients, 46 of which were females (41.1%) with a median age 6 months were enrolled. A total of 33 patients (29.5%) underwent a short therapy. All patients were successfully discharged from the acute episode, independently from antibiotic duration. Short therapy was associated with a lower risk of urinary tract relapse (22 relapses (95.6%) in the standard group, 1 (4.4%) in the short group; OR 0.081; 95%CI 0.01–0.63). Conclusions: Short antibiotic therapy was equivalent to standard duration therapy for the cure of UTIs in hospitalized children and was also associated with a lower rate of recurrences. This study provides the basis for a larger prospective randomized study to address the role of short antibiotic therapies in children with UTIs requiring hospitalization

Procalcitonin and Presepsin as Markers of Infectious Respiratory Diseases in Children: A Scoping Review of the Literature

“…One of the potential therapeutic strategies is to employ personalized treatment approaches based on the patient’s clinical conditions and the results of common blood tests, to establish treatment regimens and appropriate duration [ 61 ].…”

Predictors of Urinary Abnormalities in Children Hospitalised for Their First Urinary Tract Infection

“…Meanwhile, intravenous treatment is indicated for severe UTIs with a higher risk of complications [2]. Today, new personalised therapeutic regimens are also possible with different and/or shorter durations customised to the patient's characteristics (such as an early response to antibiotic therapy) and on the early reduction of inflammation indices [17].…”

Urinary tract infection in children - short versus standard duration antibiotic therapy

“…Dawkowanie wybranych leków w leczeniu OOZN u dzieci [4]. Na podstawie najnowszych badań wnioskuje się, że krótka antybiotykoterapia czasami może być równoważna z terapią o standardowym czasie trwania dla wyleczenia ZUM u hospitalizowanych dzieci [13]. Krótkotrwała terapia antybiotykami w przypadku infekcji dolnego odcinka układu moczowego (2-4 dniowy kurs doustnych antybiotyków) wydaje się być równie skuteczna jak standardowa terapia.…”

“…Krótkotrwała terapia antybiotykami w przypadku infekcji dolnego odcinka układu moczowego (2-4 dniowy kurs doustnych antybiotyków) wydaje się być równie skuteczna jak standardowa terapia. Badania pokazują, że krótsza antybiotykoterapia( <10dni) sprawdza się również przy odmiedniczkowych zapalaniach nerek u pacjentów pediatrycznych [13]. U dzieci, które otrzymały krótki kurs antybiotykoterapii istnieje mniejsze ryzyko narażenia na kolejne zakażenia bardziej opornym szczepem tego samego uropatogenu [16,17].…”