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Single dose trimethoprim-sulphamethoxazole treatment of symptomatic urinary infection
Insights
Single-dose trimethoprim-sulphamethoxazole is as effective as a 7-day course for treating urinary tract infections in children. This approach offers a convenient alternative for pediatric patients with symptomatic UTIs.
Area of Science:
- Pediatric infectious diseases
- Pharmacology
- Nephrology
Background:
- Urinary tract infections (UTIs) are common in children.
- Conventional treatment involves a 7-day course of antibiotics.
- Shorter treatment regimens may improve compliance and reduce side effects.
Purpose of the Study:
- To compare the efficacy of a single-dose regimen versus a 7-day course of trimethoprim-sulphamethoxazole for pediatric UTIs.
- To evaluate treatment outcomes in children with symptomatic UTIs.
Main Methods:
- A randomized trial involving 42 children with symptomatic UTIs.
- Participants were assigned to either a single-dose or a 7-day course of trimethoprim-sulphamethoxazole.
- Urine cultures were assessed for bacterial eradication.
Main Results:
- Both treatment groups achieved sterile urine cultures 2 days post-treatment.
- One recurrence of infection was noted in the single-dose group on day 7.
- Eight patients (3 in single-dose, 5 in 7-day group) had underlying renal abnormalities.
Conclusions:
- Single-dose trimethoprim-sulphamethoxazole is effective for treating pediatric UTIs.
- This regimen is comparable in efficacy to the standard 7-day course.
- Renal tract investigation is recommended irrespective of successful UTI eradication with single-dose therapy.
Abstract:
Seventy-nine children with symptoms of urinary tract infections were randomly allocated to treatment with a single dose or a 7-day course of trimethoprim-sulphamethoxazole. Of the 42 patients (39 girls, 3 boys) who fulfilled the criteria for the trial, 23 were given a single-dose regimen and 19 of them a 7-day regimen. Both groups of patients had sterile urine cultures 2 days after starting treatment. Eight patients had underlying structural renal abnormalities (n = 3, single-dose regimen; n = 5, 7-day regimen). One patient in the single dose group had a recurrence of infection on day 7. These results show that single dose trimethoprim-sulphamethoxazole is as effective as the conventional 7-day course in children with symptomatic urinary tract infection. Further investigation of the renal tract is necessary regardless of the fact that the infection has been eradicated by single-dose treatment.