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Short compared with standard duration of antibiotic treatment for urinary tract infection: a systematic review of
M Michael1, E M Hodson, J C Craig
1Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
Insights
A short course of oral antibiotics (2-4 days) is as effective as standard treatment (7-14 days) for childhood urinary tract infections (UTI). This finding supports shorter antibiotic durations for pediatric UTI, reducing potential side effects and antibiotic resistance.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
Background:
- Urinary tract infections (UTI) are common in children.
- Standard antibiotic treatment duration for pediatric UTI typically ranges from 7-14 days.
- Shorter antibiotic courses may reduce side effects and the development of antimicrobial resistance.
Purpose of the Study:
- To compare the effectiveness of short-course (2-4 days) versus standard-duration (7-14 days) oral antibiotic treatment for lower tract UTI in children.
Main Methods:
- Meta-analysis of ten randomized controlled trials involving 652 children with lower tract UTI.
- Outcomes assessed included UTI at end of treatment, recurrent UTI during follow-up, and development of antibiotic-resistant urinary pathogens.
Main Results:
- No significant difference in UTI recurrence between short-course and standard-duration antibiotic therapy at short-term (0-7 days) or long-term (10 days to 15 months) follow-up.
- No significant difference in the development of resistant organisms or recurrent UTI between the treatment groups.
Conclusions:
- A 2-4 day course of oral antibiotics is as effective as a 7-14 day course for eradicating lower tract UTI in children.
- Shorter antibiotic durations are a viable and effective treatment option for pediatric UTI.
Aims:
To compare the effectiveness of short course (2-4 days) with standard duration oral antibiotic treatment (7-14 days) for urinary tract infection (UTI).
Methods:
Meta-analysis of randomised controlled trials using a random effects model. Ten trials were eligible, involving 652 children with lower tract UTI recruited from outpatient or emergency departments. Main outcome measures were UTI at the end of treatment, UTI during follow up (recurrent UTI), and urinary pathogens resistant to the treating antibiotic.
Results:
There was no significant difference in the frequency of positive urine cultures between the short (2-4 days) and standard duration therapy (7-14 days) for UTI in children at 0-7 days after treatment (eight studies: RR 1.06; 95% CI 0.64 to 1.76) and at 10 days to 15 months after treatment (10 studies: RR 1.01; 95% CI 0.77 to 1.33). There was no significant difference between short and standard duration therapy in the development of resistant organisms in UTI at the end of treatment (one study: RR 0.57, 95% CI 0.32 to 1.01) or in recurrent UTI (three studies: RR 0.39, 95% CI 0.12 to 1.29).
Conclusion:
A 2-4 day course of oral antibiotics is as effective as 7-14 days in eradicating lower tract UTI in children.
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