Short IV antibiotic course improves urinary tract infections in young infants: AAP

Australia: A new study showed that after eliminating meningitis, shorter IV antibiotic treatments of 7 days and 3 days, respectively, with an early changeover to oral antibiotics, should be explored in babies aged 90 days with bacteremic and nonbacteremic urinary tract infections (UTI). This study was conducted by Samar Hikmat and the team. The findings of this work were published in the American Academy of Pediatrics on January 24, 2022.

UTIs are prevalent in newborns, but there is no consensus on the best length of intravenous (IV) therapy. Therefore, the objective of this study was to see if shorter IV antibiotic treatments (7 days) are effective in treating UTIs in newborns aged 90 days.

For this study data sources included PubMed, the Cochrane Library, Medline, and Embase (as of February 2021). Included studies presented original data for babies aged 90 days with UTIs, investigated short IV antibiotic durations (seven days), and detailed at least one treatment result. The guideline for Preferred Reporting Items for Systematic Reviews and Meta-analyses was followed. Two investigators reviewed the studies, and bias was assessed using the Newcastle-Ottawa Scale and the Revised Cochrane Risk-of-Bias Tool.

The result of this study stated as follows:

1. There were eighteen trials with a total of 16 615 young babies.

2. The largest two trials on bacteremic UTI discovered no difference in 30-day recurrence rates between those treated with 7 versus >7 days of IV antibiotics.

3. In the biggest two studies identified, there was no significant difference in adjusted 30-day recurrence between those receiving 3 versus >3 days of IV antibiotics for nonbacteremic UTI.

4. Despite the fact that only 85 newborns were 90 days old, three trials of infants aged 30 days took oral antibiotics alone and showed satisfactory results.

In conclusion, with the findings indicating that early use of bacteremia is beneficial, more research into therapy with oral antibiotics alone in this age range is required.

Reference:

Samar Hikmat, Jolie Lawrence, Amanda Gwee; Short Intravenous Antibiotic Courses for Urinary Infections in Young Infants: A Systematic Review. Pediatrics 2022; e2021052466. 10.1542/peds.2021-052466