Short- versus standard-course antimicrobial therapy for children with urinary tract infection: A meta-analysis

IF 2.4 4区 医学 Q1 PEDIATRICS
Acta Paediatrica Pub Date : 2024-12-17 DOI:10.1111/apa.17546
Grace D. Mueller, Shannon J. Conway, Asumi Gibeau, Nader Shaikh
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引用次数: 0

Abstract

Aim

To determine if short- (2–5 days) course antimicrobials are as effective as standard- (6–14 days) course antimicrobials in the treatment of symptomatic UTI in children.

Methods

MEDLINE and EMBASE were searched from their origin to January 2024. We only considered randomised controlled trials in children <18 years of age. The main outcomes of interest were UTI or bacteriuria at the end of therapy.

Results

Nine studies were included. Compared to children treated with a standard course of antimicrobials, those treated with shortened courses of antimicrobials did not have significantly different risks of UTI at the end of therapy (risk difference 2.2%, CI: 0.0–4.3). Risk of bacteriuria at end of therapy (RD = 8.7%, CI: 5.3–12.2) was slightly higher in children treated with shorter courses. In children with fever at baseline (two studies), there was no significant difference in risk between short and standard duration treatment (RD = 0.4%, CI: −2.8 to 3.6).

Conclusion

In children without fever at the time of presentation, treatment with shorter courses of antimicrobials appears reasonable. More studies of febrile children are needed before shorter courses could be recommended for febrile children.

Abstract Image

尿路感染儿童短期抗菌药物治疗与标准疗程抗菌药物治疗:一项荟萃分析。
目的:确定短期疗程(2-5天)抗菌药物在治疗儿童症状性尿路感染方面是否与标准疗程(6-14天)抗菌药物同样有效。方法:检索MEDLINE和EMBASE数据库自来源至2024年1月。我们只考虑了儿童的随机对照试验结果:纳入了9项研究。与接受标准疗程抗菌药物治疗的儿童相比,缩短疗程抗菌药物治疗的儿童在治疗结束时尿路感染的风险没有显著差异(风险差异2.2%,CI: 0.0-4.3)。治疗结束时细菌尿的风险(RD = 8.7%, CI: 5.3-12.2)在疗程较短的儿童中略高。在基线时发热的儿童中(两项研究),短时间治疗和标准时间治疗的风险无显著差异(RD = 0.4%, CI: -2.8至3.6)。结论:对于发病时无发热的儿童,较短疗程的抗菌药物治疗似乎是合理的。在为发热儿童推荐短期课程之前,需要对发热儿童进行更多的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta Paediatrica
Acta Paediatrica 医学-小儿科
CiteScore
6.50
自引率
5.30%
发文量
384
审稿时长
2-4 weeks
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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