{"title":"Clinical outcomes in febrile children with a positive urine culture without pyuria: Implications for antibiotics.","authors":"Rei Miyake, Hiroshi Hataya","doi":"10.1111/apa.17508","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate whether antibiotics should be administered to patients aged <2 years with a positive urine culture without pyuria by identifying their clinical characteristics and outcomes in the absence of antibiotic treatment.</p><p><strong>Methods: </strong>This retrospective, observational study included children aged <2 years with positive findings on a culture of urine obtained using a catheter in the paediatric emergency department between 2016 and 2021. The primary outcome was the spontaneous resolution of fever without antibiotics in patients with a positive urine culture without pyuria. The clinical characteristics of the patients with and without pyuria were also compared.</p><p><strong>Results: </strong>Of 391 patients, 86 (22%) were negative for pyuria. Of these, 63 (73%) received no antibiotics, and 56 (89%) had spontaneous defervescence and no symptom recurrence. The patients without pyuria had a higher proportion of other possible causes of fever, lower inflammatory markers, fewer cultured bacteria, and a higher proportion of multiple, bacterial species in their culture than the patients with pyuria.</p><p><strong>Conclusions: </strong>Most of the patients with a positive urine culture without pyuria may not require antibiotics if their fever resolves spontaneously.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Paediatrica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/apa.17508","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: This study aimed to investigate whether antibiotics should be administered to patients aged <2 years with a positive urine culture without pyuria by identifying their clinical characteristics and outcomes in the absence of antibiotic treatment.
Methods: This retrospective, observational study included children aged <2 years with positive findings on a culture of urine obtained using a catheter in the paediatric emergency department between 2016 and 2021. The primary outcome was the spontaneous resolution of fever without antibiotics in patients with a positive urine culture without pyuria. The clinical characteristics of the patients with and without pyuria were also compared.
Results: Of 391 patients, 86 (22%) were negative for pyuria. Of these, 63 (73%) received no antibiotics, and 56 (89%) had spontaneous defervescence and no symptom recurrence. The patients without pyuria had a higher proportion of other possible causes of fever, lower inflammatory markers, fewer cultured bacteria, and a higher proportion of multiple, bacterial species in their culture than the patients with pyuria.
Conclusions: Most of the patients with a positive urine culture without pyuria may not require antibiotics if their fever resolves spontaneously.
期刊介绍：
Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including:
neonatal medicine
developmental medicine
adolescent medicine
child health and environment
psychosomatic pediatrics
child health in developing countries
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