Short compared with standard duration of antibiotic treatment for urinary tract infection: a systematic review of randomised controlled trials.
OBJECTIVE
To compare the effectiveness of short course (2-4 days) with standard duration oral antibiotic treatment (7-14 days) for urinary tract infection (UTI).


METHODS
Meta-analysis of randomised controlled trials using a random effects model. Ten trials were eligible, involving 652 children with lower tract UTI recruited from outpatient or emergency departments. Main outcome measures were UTI at the end of treatment, UTI during follow up (recurrent UTI), and urinary pathogens resistant to the treating antibiotic.


RESULTS
There was no significant difference in the frequency of positive urine cultures between the short (2-4 days) and standard duration therapy (7-14 days) for UTI in children at 0-7 days after treatment (eight studies: RR 1.06; 95% CI 0.64 to 1.76) and at 10 days to 15 months after treatment (10 studies: RR 1.01; 95% CI 0.77 to 1.33). There was no significant difference between short and standard duration therapy in the development of resistant organisms in UTI at the end of treatment (one study: RR 0.57, 95% CI 0.32 to 1.01) or in recurrent UTI (three studies: RR 0.39, 95% CI 0.12 to 1.29).


CONCLUSIONS
A 2-4 day course of oral antibiotics is as effective as 7-14 days in eradicating lower tract UTI in children.
Michael
M
M
Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
Hodson
E M
EM
Craig
J C
JC
Martin
S
S
Moyer
V A
VA
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D006801:Humans; D007223:Infant; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents