Randomised controlled trial of three day versus 10 day intravenous antibiotics in acute pyelonephritis: effect on renal scarring

Details

Serval ID
serval:BIB_F01CF4926971
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Randomised controlled trial of three day versus 10 day intravenous antibiotics in acute pyelonephritis: effect on renal scarring
Journal
Archives of Disease in Childhood
Author(s)
Benador  D., Neuhaus  T. J., Papazyan  J. P., Willi  U. V., Engel-Bicik  I., Nadal  D., Slosman  D., Mermillod  B., Girardin  E.
ISSN
1468-2044
Publication state
Published
Issued date
03/2001
Peer-reviewed
Oui
Volume
84
Number
3
Pages
241-6
Notes
Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial --- Old month value: Mar
Abstract
BACKGROUND: Acute pyelonephritis often leaves children with permanent renal scarring. AIMS: To compare the prevalence of scarring following initial treatment with antibiotics administered intravenously for 10 or three days. METHODS: In a prospective two centre trial, 220 patients aged 3 months to 16 years with positive urine culture and acute renal lesions on initial DMSA scintigraphy, were randomly assigned to receive intravenous ceftriaxone (50 mg/kg once daily) for 10 or three days, followed by oral cefixime (4 mg/kg twice daily) to complete a 15 day course. After three months, scintigraphy was repeated in order to diagnose renal scars. RESULTS: Renal scarring developed in 33% of the 110 children in the 10 day intravenous group and 36% of the 110 children in the three day group. Children older than 1 year had more renal scarring than infants (42% (54/129) and 24% (22/91), respectively). After adjustment for age, sex, duration of fever before treatment, degree of inflammation, presence of vesicoureteric reflux, and the patients' recruitment centres, there was no significant difference between the two treatments on renal scarring. During follow up, 15 children had recurrence of urinary infection with no significant difference between the two treatment groups. CONCLUSION: In children with acute pyelonephritis, initial intravenous treatment for 10 days, compared with three days, does not significantly reduce the development of renal scarring.
Keywords
Acute Disease Adolescent Ceftriaxone/*administration & dosage Cephalosporins/*administration & dosage Child Child, Preschool Cicatrix/*etiology/radionuclide imaging Drug Administration Schedule Female Humans Infant Kidney Diseases/etiology/radionuclide imaging Male Pyelonephritis/complications/*drug therapy/radionuclide imaging Regression Analysis Statistics, Nonparametric Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
15/01/2008 14:28
Last modification date
20/08/2019 16:17
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