Is a Shorter Course of Antibiotics for Urinary Tract Infections in Children Safe?

Short courses of antibiotic therapy (i.e., 3–7 days) for uncomplicated urinary tract infections (UTIs) in adults have long been recommended, but whether they are safe for children is less clear. In this multisite trial, researchers randomized 664 children (age range, 2 months–10 years) with UTIs (diagnosed based on typical symptoms and lab tests) who were improving after 5 days of antibiotics to 5 additional days of antibiotics or placebo. Subjects received one of five common antibiotics (i.e., amoxicillin-clavulanate, cefixime, cefdinir, cephalexin, or trimethoprim-sulfamethoxazole). Exclusion criteria included mixed or antibiotic-resistant flora, hospitalization, and urinary tract abnormalities.

Treatment failure between day 6 and days 11 …