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A Comparison of Short Versus Long Course Intravenous Antibiotics When Treating Urinary Tract Infection in Infants <60

Fadi Zu'bi1,2, Martha Pokarowski3, Rusul Al-Kutbi3

  • 1Department of Urology, Rambam Health Care Campus, Haifa, Israel.

Clinical Pediatrics
|February 21, 2023
PubMed

Insights

Treatment duration for intravenous (IV) antibiotics in infants with urinary tract infections (UTIs) did not impact treatment failure rates. This study found that shorter or longer IV antibiotic courses showed similar outcomes for infant UTI hospitalizations.

Area of Science:

  • Pediatric Infectious Diseases
  • Neonatal Hospital Medicine
  • Clinical Pharmacology

Background:

  • Urinary tract infections (UTIs) are a frequent cause of hospitalization in infants under 60 days old.
  • Optimal duration of intravenous (IV) antibiotic therapy for UTIs in this vulnerable population remains undetermined.
  • Evidence-based guidelines for managing infant UTIs require further clarification regarding antibiotic course length.

Purpose of the Study:

  • To investigate the association between IV antibiotic therapy duration and treatment failure in infants diagnosed with UTIs.
  • To compare treatment failure rates between short (≤3 days) and long (>3 days) IV antibiotic courses in hospitalized infants.
  • To provide data-driven insights into the management of infant UTIs and antibiotic stewardship.

Main Methods:

  • Retrospective review of 403 infants hospitalized with confirmed UTIs receiving IV antibiotics at a tertiary referral center.
  • Analysis of antibiotic regimens, including ampicillin with cefotaxime or gentamicin/tobramycin.
  • Comparison of treatment failure rates based on IV antibiotic duration (short vs. long course).

Main Results:

  • The median IV antibiotic duration was 5 days (IQR: 3-10 days).
  • Overall treatment failure rate was 5%, with no significant difference between short- and long-course IV antibiotic groups (P > .05).
  • No significant association was found between IV antibiotic treatment duration and treatment failure in infants with UTIs.

Conclusions:

  • Treatment failure is uncommon in infants hospitalized with UTIs.
  • The duration of IV antibiotic therapy (short vs. long course) is not significantly associated with treatment failure.
  • Findings suggest flexibility in IV antibiotic duration for hospitalized infants with UTIs, warranting further prospective studies.

Keywords:
infantsintravenous antibioticsreadmissionurinary tract infection

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