Pediatr Infect Vaccine.  2023 Aug;30(2):55-61. 10.14776/piv.2023.30.e10.

Effectiveness of Short-Course Antibiotic Treatment in Uncomplicated, Non-Bacteremic Pediatric Urinary Tract Infections: A Rapid Systematic Review

• Kim HH
• Choe YJ

• KMID: 2549035
• DOI: http://doi.org/10.14776/piv.2023.30.e10

Abstract

Purpose
Urinary tract infections (UTIs) pose a significant disease burden in children. This study aims to determine whether a short-course regimen is non-inferior to a standard-course regimen in children with UTIs without complication and presence of bacteremia, and to define, in the optimal way possible, the term “short-course” in this context.
Methods
We conducted a rapid systematic review of research up to April 2021 in PubMed, Embase, and Cochrane databases. We included studies that compared clinical outcomes in pediatric UTIs treated with short-course(≤4 days) or standard (≥5–7 days) courses.
Results
Our analysis suggests that short-course regimes have equivalent efficacy to standardcourse regimens, with similar clinical cure rates and recurrence rates. All 10 studies comparing the clinical cure rates of short- and standard-course regimens reported comparable outcomes. The study evaluating renal scarring indicated no inferiority of short-course regimens compared to standard-course ones. Regarding UTI relapse, 8 out of 10 studies reported no significant difference in outcomes between short- and standard-course regimens.
Conclusions
Our results purpose that short-course UTI regimens of 6 days or less are just as effective as standard-term regimens of 7 days or more in terms of infection cure and prevention of recurrence. Considering the equivalent rates of clinical cure and relapse between short- and standard-course regimens, it could be inferred that short-course regimens might be a more optimal strategy for managing pediatric UTIs without increasing the risk of complications.

Keyword

Urinary tract infections; Children; Therapeutics; Antibiotic