Related Experiment Video
Updated: Jun 25, 2025
08:53
Recurrent Escherichia coli Urinary Tract Infection Triggered by Gardnerella vaginalis Bladder Exposure in Mice
Published on: December 4, 2020
6.0K
Use of Fever Duration to Guide Management of Urinary Tract Infection
Takeshi Yanagihara1,2, Koichi Kobayashi1, Emi Yanai2
1Department of Pediatrics, Nippon Medical School Hospital.
Summary
A new protocol using fever duration to guide antibiotic treatment for febrile urinary tract infections (fUTI) in children proved effective. This approach eliminated the need for invasive imaging like computed tomography scans.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial stewardship
Background:
- The optimal duration of antimicrobial therapy for febrile urinary tract infections (fUTI) in children remains undefined.
- Establishing evidence-based treatment guidelines is crucial for effective pediatric care.
Purpose of the Study:
- To evaluate a novel protocol for determining antimicrobial treatment duration in pediatric fUTI based on fever resolution.
- To assess the efficacy and necessity of advanced imaging in diagnosing fUTI complications.
Main Methods:
- A protocol was implemented where antibiotic administration continued until 3 days post-fever resolution, followed by oral therapy.
- Febrile urinary tract infection diagnosis required a temperature of ≥37.5°C and urine culture counts of ≥5 × 10⁴ CFU/mL.
- Contrast-enhanced computed tomography (eCT) was used to diagnose acute focal bacterial nephritis (AFBN) and pyelonephritis (PN).
Main Results:
- Of 58 analyzed patients, 49 had pyelonephritis (PN) and nine had acute focal bacterial nephritis (AFBN).
- Patients with AFBN showed higher white blood cell counts and C-reactive protein levels, but similar urinary findings and causative bacteria compared to PN.
- While AFBN patients had longer fever resolution and IV antibiotic durations, the average AFBN treatment was 14.2 days, shorter than previous reports, with no recurrences.
Conclusions:
- A fever-duration-guided antimicrobial treatment protocol is effective for pediatric fUTI.
- The study suggests that invasive imaging like eCT may not be necessary for managing fUTI and its complications.
Related Concept Videos
01:25Increased Body Temperature
663
A body temperature above 38°C (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in...
663
01:26Tonsillitis II: Management
110
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
110
01:22Methods of reducing fever
661
The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
Pharmacological Methods of Reducing Fever:
661
01:26Patterns of Fever
2.5K
Before understanding the types and patterns of fever, it is essential to know its phases.
2.5K
01:30Acute Pharyngitis
584
Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
584
01:28Pneumonia IV: Management
322
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
322