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Risk Factors for Delayed Antimicrobial Treatment in Febrile Children with Urinary Tract Infections

Stephanie W Hum1, Nader Shaikh1

  • 1University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Academic Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.

The Journal of Pediatrics
|October 21, 2018
PubMed

Insights

Older children with urinary tract infections (UTI) experienced delayed antimicrobial treatment. Prompt evaluation and management are crucial to prevent potential renal scarring in these pediatric patients.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Research

Background:

  • Urinary tract infections (UTI) are common in children.
  • Delayed antimicrobial treatment in pediatric UTI can lead to serious complications like renal scarring.
  • Identifying predictors of treatment delay is crucial for timely intervention.

Purpose of the Study:

  • To identify factors associated with delayed antimicrobial treatment in febrile children diagnosed with urinary tract infection (UTI).

Main Methods:

  • A retrospective analysis of data from 802 children with UTI enrolled in two prospective studies.
  • Investigated predictors including age, sex, prior UTI history, ethnicity, race, caregiver education, insurance, and income.
  • Utilized univariate and multivariable analyses to assess the relationship between predictors and treatment delay.

Main Results:

  • Older age (≥12 months) and commercial insurance were significantly associated with delayed antimicrobial treatment.
  • Children 12 months and older experienced an average delay of 26.2 hours.
  • Patients with commercial insurance had an average delay of 12.6 hours; race, ethnicity, caregiver education, and income were not significant predictors.

Conclusions:

  • Older age is a consistent predictor of delayed antimicrobial treatment for pediatric UTI.
  • Prompt initiation of antimicrobial therapy is essential to mitigate the risk of renal scarring.
  • Educational initiatives for parents of older children and healthcare providers are recommended to improve fever management and prompt UTI evaluation.
Abstract

Keywords:
UTIurinary tract infection

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