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Late renal sequelae in intravenously treated complicated urinary tract infection

Christine Ferreiro1, Amy Piepsz, Cécile Nogarède

  • 1Department of Pediatrics, Hospital Saint- Pierre, Université Libre de Bruxelles, Brussels, Belgium.

European Journal of Pediatrics
|May 17, 2013
PubMed

Insights

Complicated urinary tract infections (UTIs) in children treated with 7-day intravenous antibiotics showed infrequent late renal sequelae on technetium-99m dimercaptosuccinic acid (DMSA) scans. Further research is needed to confirm treatment efficacy.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Diagnostic Imaging

Background:

  • Treatment for complicated pediatric urinary tract infections (UTIs) remains debated.
  • Intravenous antimicrobial therapy is initiated, with duration guided by technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy results.

Purpose of the Study:

  • To retrospectively evaluate the frequency and significance of late renal sequelae.
  • Assessed outcomes in children with abnormal acute DMSA findings treated intravenously for 7 days.

Main Methods:

  • Retrospective review of medical charts for pediatric patients (2005-2008).
  • Inclusion criteria: positive urine culture and evidence of complicated UTI.
  • Analysis of early and late DMSA scintigraphy results.

Main Results:

  • 144 patients (59%) had abnormal early DMSA; 98 (41%) had normal scans.
  • Median IV treatment duration was 7 days for those with DMSA lesions, 5 days for others.
  • Late renal sequelae occurred in 6% (4/65) of patients with abnormal early DMSA who had follow-up scans.

Conclusions:

  • Late renal sequelae following complicated UTI treated with 7-day IV antibiotics were infrequent.
  • The study suggests a low rate of sequelae, but the optimal treatment mode and duration require further investigation.
Abstract

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