title: Bacteraemic urinary tract infection: management and outcomes in young infants.
abstract: OBJECTIVE
  To determine predictors of parenteral antibiotic duration and the association between parenteral treatment duration and relapses in infants <3 months with bacteraemic urinary tract infection (UTI).
  
  
  METHODS
  Multicentre retrospective cohort study.
  
  
  METHODS
  Eleven healthcare institutions across the USA.
  
  
  METHODS
  Infants <3 months of age with bacteraemic UTI, defined as the same pathogenic organism isolated from blood and urine.
  
  
  METHODS
  Duration of parenteral antibiotic therapy, relapsed UTI within 30 days.
  
  
  RESULTS
  The mean (±SD) duration of parenteral antibiotics for the 251 included infants was 7.8 days (±4 days), with considerable variability between institutions (mean range 5.5-12 days). Independent predictors of the duration of parenteral antibiotic therapy included (coefficient, 95% CI): age (-0.2 days, -0.3 days to -0.08 days, for each week older), year treated (-0.2 days, -0.4 to -0.03 days for each subsequent calendar year), male gender (0.9 days, 0.01 to 1.8 days), a positive repeat blood culture during acute treatment (3.5 days, 1.2-5.9 days) and a non-Escherichia coli organism (2.2 days, 0.8-3.6 days). No infants had a relapsed bacteraemic UTI. Six infants (2.4%) had a relapsed UTI (without bacteraemia). The duration of parenteral antibiotics did not differ between infants with and without a relapse (8.2 vs 7.8 days, p=0.81).
  
  
  CONCLUSIONS
  Parenteral antibiotic treatment duration in young infants with bacteraemic UTI was variable and only minimally explained by measurable patient factors. Relapses were rare and were not associated with treatment duration. Shorter parenteral courses may be appropriate in some infants.
authors.affiliation: Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, California, USA Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Schroeder
authors.affiliation: Department of Pediatrics, Dell Children's Medical Center, Austin, Texas, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Shen
authors.affiliation: Department of Pediatrics, University of Rochester, Rochester, New York, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Biondi
authors.affiliation: Department of Pediatrics, Children's Hospital and Clinics of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Bendel-Stenzel
authors.affiliation: Department of Pediatrics, University of Texas Southwestern, Dallas, Texas, USA.
authors.forename: Clifford N
authors.initials: CN
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: French
authors.affiliation: Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Children's Hospital of the King's Daughters, Norfolk, Virginia, USA.
authors.forename: Rianna C
authors.initials: RC
authors.lastname: Evans
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Jerardi
authors.affiliation: Department of Pediatrics, Children's Hospital of Illinois, Peoria, Illinois, USA.
authors.forename: Matt
authors.initials: M
authors.lastname: Mischler
authors.affiliation: Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa, USA.
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Wood
authors.affiliation: Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, California, USA Stanford University School of Medicine, Stanford, California, USA Department of Pediatrics, Kaiser Permanente Northern California, San Francisco, California, USA.
authors.forename: Pearl W
authors.initials: PW
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, California, USA Stanford University School of Medicine, Stanford, California, USA Department of Pediatrics, University of Texas Southwestern, Dallas, Texas, USA.
authors.forename: Heidi K
authors.initials: HK
authors.lastname: Roman
authors.affiliation: Department of Pediatrics, Kaiser Permanente Northern California, San Francisco, California, USA.
authors.forename: Tara L
authors.initials: TL
authors.lastname: Greenhow
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D001831:Body Temperature; D019468:Disease Management; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007263:Infusions, Parenteral; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: General Paediatrics; Infectious Diseases