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Many experts believe that early antibiotic treatment of pyelonephritis in children might prevent the development of renal scars. As part of a randomized clinical trial in which 287 children (age range, 1 month to 7 years) with pyelonephritis (confirmed by dimercaptosuccinic acid [DMSA] scan) received different antibiotic regimens, Italian investigators assessed response to therapy and the association between duration of fever before treatment and renal scarring 12 months after treatment.
No relation was found between scars on DMSA scan at 12 months and the number of days of fever (from <1 day to ≥5 days) before the start of antibiotic treatment (about 30% of children had scars, regardless of duration of fever). Duration of fever after initia…