Treatment of children with acute pyelonephritis: a prospective randomized study.
The aim of this study was to compare, in children with acute pyelonephritis, the efficacy of 7 days' (group A) and 3 days' (group B) intravenous antibiotics, both followed by an oral treatment. Children were randomized after 3 days of intravenous treatment. Technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy was performed within the first days after admission and repeated 6 months later. Total or partial persistence of renal abnormalities on the 6-month DMSA scintigraphy was used as the endpoint of the study. Among the 92 children included in the study, 87 were followed for at least 6 months (43 in group A and 44 in group B) and were eligible for analysis. Late DMSA was abnormal in 9 kidneys of group A and 12 kidneys of group B, representing respectively 24% and 44% of kidneys with abnormalities on the initial DMSA (difference statistically not significant). When the patients were stratified according to the delay of treatment, the percentage of patients with sequelae in group A was comparable, whether the delay was less or more than 1 week. In group B, the percentage of patients with sequelae was significantly higher (P<0.01) when the delay was more than 1 week.
Levtchenko
E
E
Department of Pediatrics, AZ VUB, Brussels, Belgium.
Lahy
C
C
Levy
J
J
Ham
H
H
Piepsz
A
A
D000208:Acute Disease; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002675:Child, Preschool; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D007668:Kidney / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011704:Pyelonephritis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D011859:Radiography; D011877:Radionuclide Imaging; D012008:Recurrence; D004113:Succimer / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D004113:Succimer