Pediatrics
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Meta Analysis Comparative Study
A meta-analysis of randomized, controlled trials comparing short- and long-course antibiotic therapy for urinary tract infections in children.
Short-course antibiotic regimens, ranging in duration from a single dose to 3 days, are the current standard of care for the treatment of acute lower urinary tract infections (UTIs) in adult women. Despite multiple small randomized, controlled trials (RCTs) showing no difference in efficacy between short-course (=3 days) and long-course (7-14 days) therapy in children, concerns about occult pyelonephritis and renal scarring have prompted standard recommendations of 7 to 14 days of antibiotics for UTIs in children. ⋯ In pooled analyses of published studies comparing long- and short-course antibiotic treatment of UTI in children, long-course therapy was associated with fewer treatment failures without a concomitant increase in reinfections, even when studies including patients with evidence of pyelonephritis were excluded from the analysis. Until there are more accurate methods for distinguishing upper from lower UTI in children, no additional comparative trials are warranted and clinicians should continue to treat children with UTI for 7 to 14 days.