For Managing Febrile Urinary Tract Infections in Young Children, Shorter Duration May Be Better — or at Least as Good

Most children with uncomplicated febrile urinary tract infection (UTI) receive oral antibiotics, typically for 10 days. But is this traditional duration evidence based? In a multicenter trial, Italian investigators assessed recurrent infection within 30 days of completing 5-day versus 10-day treatment courses. Secondary end points were clinical response, adverse events, and antibiotic resistance.

In all, 140 children with febrile UTIs were randomized 1:1 on day 5 of antibiotic treatment (amoxicillin-clavulanate) to either stopping therapy or adding an additional 5 days of antibiotics, with follow-up for microscopic urine examination 5 and 30 days, respectively, after antibiotic completion. Key findings were:

• E. coli was the primary causative …