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Short-course intravenous antibiotics for young infants with urinary tract infection

Jolie Lawrence1, Laure F Pittet2,3, Samar Hikmat3

  • 1Department of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia jolie.lawrence@rch.org.au.

Archives of Disease in Childhood
|April 26, 2022
PubMed

Insights

Shorter intravenous antibiotic courses for infant urinary tract infections (UTI) are safe, with low treatment failure rates. Early switch to oral antibiotics is feasible for non-bacteraemic UTI, provided meningitis is excluded.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Neonatal Care

Background:

  • Urinary tract infections (UTI) are common in young infants.
  • Current practices often involve prolonged intravenous antibiotic courses.
  • Shorter antibiotic durations offer potential benefits.

Purpose of the Study:

  • To assess the safety of early intravenous-to-oral antibiotic switch in infants with UTI.
  • To identify risk factors for bacteremia in infants with UTI.
  • To evaluate the efficacy of short-course intravenous antibiotic treatment.

Main Methods:

  • Retrospective audit of infants aged ≤90 days with UTI over 4 years.
  • Data collected from electronic medical records and laboratory systems.
  • Defined short-course intravenous antibiotics as <48 hours for non-bacteraemic UTI and <7 days for bacteraemic UTI.

Main Results:

  • 60.2% of non-bacteraemic UTI cases received <48 hours of IV antibiotics.
  • Treatment failure occurred in 1.3% of infants, primarily in non-bacteraemic cases.
  • Bacteremia occurred in 5.3% of infants; fever and pyelonephritis predicted bacteremia.

Conclusions:

  • Short-course IV antibiotics (<48 hours) are safe for non-bacteraemic UTI in young infants if meningitis is excluded.
  • Treatment failure and serious complications were infrequent.
  • Early switch to oral antibiotics can be considered.
Abstract

Keywords:
infectious disease medicinepaediatrics

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