[Pyelonephritis treatment in children in 2007: current literature review].
Four studies, including two being published as an abstract, have recently demonstrated the feasibility of oral treatment of pyelonephritis in children, with no increased risk of treatment failure, early urinary tract re-infection, or renal scars. To do so, the pediatrician must ensure that: (1) the patient does not appear toxic, has no vomiting; (2) there is no known severe obstructive or refluxing uropathy and (3) parents are deemed to be adherent to the treatment. If these criteria are fulfilled, the pediatrician can start an oral treatment with a 3rd generation cephalosporine for 10 to 14 days. Ambulatory follow-up is crucial, and persistance of fever after 3 days is a reason for a new outpatient visit, additional or supplementary imaging studies (renal ultrasonography) and eventually a switch to intravenous treatment.
Cachat
François
F
Département médico-chirurgical de pédiatrie, Unité romande de néphrologie pédiatrique, CHUV, Lausanne. Francois.Cachat@chuv.ch
Zeier
Gregory
G
Parvex
Paloma
P
Girardin
Eric
E
Von Vigier
Rodo
R
Konrad
Martin
M
Rudin
Christoph
C
Neuhaus
Thomas
T
D000284:Administration, Oral; D002648:Child; D006801:Humans; D007275:Injections, Intravenous; D011704:Pyelonephritis / Q000188:drug therapy*