Oral vs. Parenteral Antibiotics for Pyelonephritis in Children

Initiating therapy with oral antibiotics was as effective as initiating therapy with parenteral antibiotics.

No consensus exists that children with pyelonephritis need initial treatment with parenteral antibiotics. In an Italian multisite randomized clinical trial, 502 children (age range, 1 month to <7 years) with a clinical diagnosis of pyelonephritis and no documented urinary tract abnormality on prenatal ultrasound were hospitalized for at least 3 days and received either oral amoxicillin/clavulanate for 10 days or parenteral ceftriaxone for 3 days followed by oral amoxicillin/clavulanate for 7 days.

The rate of renal scarring at 12 months (the primary outcome) was similar in the oral and parenteral groups (13.7% vs. 17.7%). No significant differences were found in time to defervescence, reduction in white blood cell count, or urine sterility a…

Reviewing Author

Howard Bauchner, MD

Disclosures

Grant / research supportHuman Resources and Services Administration; NIH; NIH-NHLBI; USDA; GlaxoSmithKline

Editorial boardsArchives of Disease in Childhood (Editor-in-Chief)

Howard Bauchner, MD

Disclosures

Grant / research supportHuman Resources and Services Administration; NIH; NIH-NHLBI; USDA; GlaxoSmithKline

Editorial boardsArchives of Disease in Childhood (Editor-in-Chief)