Evaluation of the safety of an Oral treatment for febrile Urinary Tract Infection in children aged 6 months to 5 years
CPS ePoster Library. Taylor G. Jun 25, 2015; 99212; 150
Dre Geneviève Taylor
Dre Geneviève Taylor
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Evaluation of the safety of an oral treatment for febrile urinary tract infection in children aged 6 months to 5 years
Geneviève Taylor, MD, FRCPC; Andrée-Anne Boisvert, MD; Chantal Guimont, MD, PhD

Background: Prompt treatment of febrile UTI is required to decrease the risk of short and long term complications. The literature supports the use of an empirical oral treatment in comparison with the usual IV treatment.
Objectives: To compare the rate of treatment failure (fever more than 96 hours, non-compliance with follow-up, modification of empiric antibiotic before culture result, hospitalisation or positive urine culture in the following month) between patients treated with intravenous (IV) or oral empiric antibiotic and to compare the rate of adverse events and complications.
Methodology: A retrospective study was conducted with patients aged 6 months to 5 years comparing the group of patient treated before and the one treated after the implementation of a new empirical ambulatory oral treatment protocol (cefixime). The IV group (ampicillin and gentamicin) included 122 patients from April 2010 to September 2011. The oral group included 111 patients from September 2011 to July 2013. Included patients needed to have a suspected UTI (presence of fever and abnormal microscopic analysis) at the presentation in the emergency department and a confirmed infection on the urine culture. Bivariate analyses were used to compare the 2 groups.

Results: Both groups had similar characteristics for sex, age, clinical presentation and the identified bacteria. A statistically significant difference in treatment failure was found between the 2 groups (p = 0,04). However, when considering only hospitalisation and positive urine culture, the difference between both groups became non-significant (p=0,16). Hospitalisation rate was similar in both groups (5% vs 6%). There was no difference for the treatment adverse events (27% vs 26%) and the complications. 20% of patients in the IV group had a problem with the IV access.

Conclusion: This study confirms that the advantages of administering an oral treatment for the febrile UTI outweigh the risks when appropriate clinical and laboratory follow-up are initiated.
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