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Antibiotic treatment for five days is effective in children with acute cystitis
K Abrahamsson1, S Hansson, P Larsson
1Department of Paediatric Surgery, The Queen Silvia Children 's Hospital, Göteborg, Sweden. kaab0001@telia.com
Insights
A 5-day antibiotic course is sufficient for treating acute cystitis in children, showing excellent short-term outcomes. Routine follow-ups may not be necessary for uncomplicated cases, simplifying pediatric urinary tract infection management.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Antibiotic Stewardship
Background:
- Short-term antibiotic therapy is common for pediatric acute cystitis, but evidence supporting its efficacy is limited.
- This study addresses the need for data on the effectiveness of short antibiotic courses in children.
Purpose of the Study:
- To evaluate the short-term outcomes of antibiotic treatment for acute cystitis in children.
- To determine the adequacy of a 5-day antibiotic regimen.
Main Methods:
- Retrospective analysis of 300 children (252 female, 48 male) with first-time acute cystitis.
- Treatment protocols involved 5, 7, or 10-day courses of nitrofurantoin or trimethoprim-based antibiotics.
Main Results:
- 96% of children were symptom-free at a median 6-day follow-up.
- Bacteriological treatment failure occurred in only 1% of cases (2 girls).
- Recurrence within 30 days was observed in 2% of cases (4 girls).
Conclusions:
- A 5-day antibiotic course is adequate for treating acute cystitis in children.
- Routine follow-up may be unnecessary for uncomplicated cases with sensitive bacteria and normal bladder/bowel function.
Unlabelled:
Short courses of antibiotics are often recommended to treat children with acute cystitis despite lack of firm evidence to support such management. The aim of this study therefore was to analyse the short-term outcome of such treatment. The retrospective analysis included 300 children (252F, 48M) fulfilling the criteria of first-time acute cystitis and managed according to a protocol recommending 5 d treatment. In 214 (71%) the treatment was given according to the protocol and in the others for 7 or 10 d. Nitrofurantoin was used in 150 (50%) and trimethoprim without or with sulfonamide in 129 (43%). The short-term results were excellent with 96% of the children being free from symptoms at the first follow-up visit after a median of 6 d. Only 2 girls had persisting bacteriuria and thus the frequency of bacteriological treatment failure was 1%. Recurrence within 30 d occurred in 4 girls (2%).
Conclusion:
A 5 d treatment with antibiotics is adequate in children with acute cystitis. Routine follow-up visits after a first acute cystitis may not be necessary, providing that the bacteria causing the infection are sensitive to the prescribed antibiotic and that there is no history of defective bladder or bowel emptying.