NEW YORK (Reuters Health) – A course of intravenous antibiotic therapy lasting no more than 3 days for hospitalized infants with urinary tract infections is just as successful as a course lasting 4 days or more, according to a study published in the August edition of Pediatrics released online July 12.

“Consensus guidelines and meta-analyses consistently have supported 7 to 14 days of antibiotic therapy for children with UTIs,” write Dr. Patrick W. Brady, of Cincinnati Children’s Hospital, Ohio, and colleagues. “Greater uncertainty exists regarding the proper route for initial antibiotic therapy and what additional benefit, if any, is conferred by longer courses of intravenous antibiotic therapy.”

To test their hypothesis that treatment failure rates would be similar regardless of the length of intravenous therapy, the team conducted a retrospective study of more than 12,000 generally healthy infants less than 6 months old who received IV antibiotics for up to 14 days for acute UTI or pyelonephritis.

Treatment failure, defined as readmission within 30 days after discharge, occurred rarely, in only 240 of the infants. The failure rate was 1.6% in the children who received a short course (up to 3 days) of intravenous antibiotic treatment and 2.2% in children who received a longer course. After adjustment, the difference was not significant (odds ratio 1.02).

An increased risk of treatment failure was associated with severity of illness and known genitourinary tract anomalies.

Concluding, the authors write: “It is likely that treating more infants with short-course intravenous antibiotic therapy would decrease the length of hospitalization for children and families without affecting the readmission rate.”

Reference:

Duration of Inpatient Intravenous Antibiotic Therapy and Treatment Failure in Infants Hospitalized With Urinary Tract Infections

Pediatrics 2010; 126.