[Pyelonephritis treatment in children in 2007: current literature review]

Area of Science:

• Pediatric Nephrology
• Infectious Diseases

Context:

• Pyelonephritis is a serious kidney infection in children.
• Traditionally treated with intravenous antibiotics.
• Oral antibiotic therapy is increasingly explored.

Purpose:

• To evaluate the feasibility and safety of oral antibiotic treatment for pediatric pyelonephritis.
• To identify criteria for selecting appropriate candidates for oral therapy.
• To assess outcomes including treatment failure, re-infection, and renal scarring.

Summary:

• Four studies indicate oral treatment for pediatric pyelonephritis is feasible.
• Key criteria include: non-toxic appearance, no vomiting, absence of severe uropathy, and parental adherence.
• Oral therapy with 3rd generation cephalosporins for 10-14 days is recommended.
• Close ambulatory follow-up is essential, with fever persistence prompting further evaluation.

Impact:

• Oral treatment offers a viable, potentially less invasive alternative for select pediatric pyelonephritis cases.
• Successful implementation can reduce healthcare costs and improve patient comfort.
• Establishes clear guidelines for pediatricians to safely administer oral antibiotics for this condition.