Efficacy of short course versus standard course oral co-trimoxazole in the management of children with lower urinary tract infections.

Abstract

Objective: To compare the efficacy of short course versus standard course oral co-trimoxazole in the management of children presenting with lower urinary tract infections. Study Design: Randomized Controlled Trial. Setting: Department of Paediatric, Federal Government Polyclinic, Islamabad. Period: 6 months from January 2017 to June 2017. Material & Methods: Patients were randomly allocated to two therapy groups by lottery method i.e. oral co-trimoxamole for 3 days (Group A) and oral co-trimoxazole for 10 days (Group B). The antibiotic course was started according to child weight and stopped after 3 and 10 days according to study group allocation. The patients were followed up after 7 days in the short course group and 10 days in the standard therapy group to assess for clinical resolution of UTI. The outcome was noted as clinical cure or relapse/recurrence of UTI. The children with recurrence were sent home after change of therapy to next generation of antibiotic therapy and in case of severe condition, patient was admitted for parenteral therapy. Results: In this study efficacy of short course was seen in 41(85.4%) patients while patients who were given standard course among they m efficacy was seen in only 14(29.2%) patients only. Efficacy of short course treatment was significantly higher as that of that of standard course i.e. p-value=0.000. Efficacy of both treatment regimens was seen in terms of age, gender and duration of symptoms. Stratification of these variables showed that short course efficacy was significantly higher as that of standard course for all these stratified variables. Conclusion: Results of this study demonstrated that short course of oral co-trimoxazole is more effective than standard course in the management of children presenting with lower urinary tract infections. However short course is not only beneficial in terms of cost as well as it cures in a short time span and minimal side effects.