Bacteraemic urinary tract infection: management and outcomes in young infants

ObjectivesTo determine predictors of parenteral antibiotic duration and the association between parenteral treatment duration and relapses in infants <3 months with bacteraemic urinary tract infection (UTI).DesignMulticentre retrospective cohort study.SettingEleven healthcare institutions across...

Full description

Saved in:

Bibliographic Details
Published in:	Archives of disease in childhood Vol. 101; no. 2; pp. 125 - 130
Main Authors:	Schroeder, Alan R, Shen, Mark W, Biondi, Eric A, Bendel-Stenzel, Michael, Chen, Clifford N, French, Jason, Lee, Vivian, Evans, Rianna C, Jerardi, Karen E, Mischler, Matt, Wood, Kelly E, Chang, Pearl W, Roman, Heidi K, Greenhow, Tara L
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group Ltd 01-02-2016 BMJ Publishing Group LTD
Subjects:	Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Antibiotics Bacteremia Bacteremia - drug therapy Bacteremia - microbiology Blood Body Temperature Care and treatment Causes of Children & youth Congenital Impairments Diagnosis Disease Management Drug Administration Schedule E coli Epidemiology Female Health aspects Hospitals Humans Infant Infant, Newborn Infants Infusions, Parenteral Intensive care Male Meningitis Parenteral feeding Parenteral nutrition Parenteral therapy Predictor Variables Recurrence Regression (Statistics) Retrospective Studies Risk factors Statistical Analysis Treatment Outcome Urinary tract diseases Urinary tract infections Urinary Tract Infections - drug therapy Urinary Tract Infections - microbiology Urogenital system Variables Young Children Los Angeles California United States > US Texas Illinois Northern California Minnesota California Santa Clara Valley Infectious Diseases General Paediatrics
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	ObjectivesTo determine predictors of parenteral antibiotic duration and the association between parenteral treatment duration and relapses in infants <3 months with bacteraemic urinary tract infection (UTI).DesignMulticentre retrospective cohort study.SettingEleven healthcare institutions across the USA.PatientsInfants <3 months of age with bacteraemic UTI, defined as the same pathogenic organism isolated from blood and urine.Main outcome measuresDuration of parenteral antibiotic therapy, relapsed UTI within 30 days.ResultsThe mean (±SD) duration of parenteral antibiotics for the 251 included infants was 7.8 days (±4 days), with considerable variability between institutions (mean range 5.5–12 days). Independent predictors of the duration of parenteral antibiotic therapy included (coefficient, 95% CI): age (−0.2 days, −0.3 days to −0.08 days, for each week older), year treated (−0.2 days, −0.4 to −0.03 days for each subsequent calendar year), male gender (0.9 days, 0.01 to 1.8 days), a positive repeat blood culture during acute treatment (3.5 days, 1.2–5.9 days) and a non-Escherichia coli organism (2.2 days, 0.8–3.6 days). No infants had a relapsed bacteraemic UTI. Six infants (2.4%) had a relapsed UTI (without bacteraemia). The duration of parenteral antibiotics did not differ between infants with and without a relapse (8.2 vs 7.8 days, p=0.81).ConclusionsParenteral antibiotic treatment duration in young infants with bacteraemic UTI was variable and only minimally explained by measurable patient factors. Relapses were rare and were not associated with treatment duration. Shorter parenteral courses may be appropriate in some infants.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-9888 1468-2044
DOI:	10.1136/archdischild-2014-307997