Out-patient antibiotics switch therapy in pediatric urinary tract infection

To compare the outcomes of out-patient antibiotics switch therapy with the treatment provided in the hospital among pediatric urinary tract infection (UTI) cases.

A comparative study was carried out using the febrile UTI patients of age 1 month-15 years in the observation room (OPD), Queen Sirikit National Institute of Child Health, Bangkok, Thailand, from 1st January 2000 to 31st December 2000 and the admitted pediatric UTI cases during the same period. The treatment at the OPD was started with parenteral antibiotics, then switched to oral form when the patients were clinically improved and defervesence occurred.

There were 95 cases of pediatric UTI of which 29 cases were treated in the observation room as out-patient, 66 cases were treated as in patients after admitting them. The success rate of treatment was the same in both groups. The patients in the observation room were fit enough to be discharged but continued oral treatment within 1.93 +/- 0.65 days, compared with 6.24 +/- 2.72 days of the admitted group. Gentamicin and ceftriazone were the two most common parenteral antibiotics and norfloxacin was the most commonly prescribed oral antibiotics in both group. Mean age of the OPD group (6.24 +/- 2.72 years) was higher than the admitted group (0.97 +/- 1.7 year). Escherichia coli (E. coli) was the most commonly found organism in the urine culture and the sensitivity pattern was the same in both groups.

The study revealed that some pediatric UTI patients can be treated as out-patients using antibiotics switch therapy in the observation room instead of being admitted.