[Antibiotic treatment of pyelonephritis in children. Recent advances]

Area of Science:

• Pediatrics
• Infectious Diseases
• Nephrology

Background:

• Urinary tract infection (UTI) is a frequent bacterial infection in infants, affecting 5% of febrile infants aged 2-24 months.
• Febrile UTIs can lead to renal scarring in 10-20% of cases, with unclear long-term consequences like hypertension or proteinuria.
• Traditional treatment involved aggressive, long-term intravenous antibiotics to prevent sepsis and renal damage.

Observation:

• Recent research indicates that oral antibiotic therapy is a viable alternative for treating febrile UTIs in children.
• Specific oral antibiotics, including cefixime and amoxicillin/clavulanic acid, have been studied for their efficacy.
• Treatment duration of 10 to 14 days with oral agents is being explored.

Findings:

• Oral antibiotics, such as cefixime or amoxicillin/clavulanic acid, appear effective for treating febrile UTIs in children.
• Shorter treatment durations (10-14 days) with oral antibiotics may be sufficient.
• This approach may reduce the need for prolonged intravenous administration.

Implications:

• Oral antibiotic treatment for febrile UTIs could simplify management and reduce healthcare costs.
• Effective treatment may decrease the incidence of long-term renal complications from UTIs in children.
• Further research is needed to confirm long-term outcomes and optimal antibiotic choices.