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The observation that a significant percentage of children who develop chronic renal failure have a history of urinary tract infection (UTI) and vesicoureteral reflux (VUR) has led to interest in the optimal treatment of pyelonephritis. In a recent, comprehensive Cochrane review, data from 18 trials involving 2612 children were analyzed to assess the efficacy of different antibiotic regimens. Among the important findings were the following:
Oral antibiotics for 10-14 days versus intravenous ceftriaxone plus oral antibiotics (2 trials, 693 children). No significant differences were found in time to resolution of fever, UTI recurrences within 6 months, or size of persistent renal parenchymal defects on a dimercaptosuccinic-acid (DMSA) scan at 6…