Short term antibiotics equally effective for bacteremic UTIs in infants

Sanyukta Desai, the University of Cincinnati and Cincinnati Children’s Hospital, and colleagues determined the association between parenteral antibiotic duration and outcomes in infants ≤60 days old with bacteremic urinary tract infection (UTI) in this multicenter, retrospective cohort study.

The researchers analyzed 115 infants aged 60 days or younger who were admitted to a group of 11 participating EDs between July 1, 2011, and June 30, 2016, if they had a UTI caused by a bacterial pathogen. Half of them were given parenteral antibiotics for 7 days or less before being switched to oral antibiotics, and the rest were given parenteral antibiotics for more than 7 days before switching to oral. Infants were more likely to receive long-term parenteral treatment if they were ill-appearing and had growth of a non–Escherichia coli organism.

"This study uniquely affords granularity with respect to the patient population, including a physician’s documented clinical assessment providing information such as temperature, ill appearance, or presence of a known genitourinary condition, which allowed for ascertainment of critical clinical information that influenced management decisions," Natalia V. Leva, MD, and Hillary L. Copp, the University of California, San Francisco, wrote in an accompanying editorial.

“Researchers in future prospective studies should seek to establish the bioavailability and optimal dosing of oral antibiotics in young infants and assess if there are particular subpopulations of infants with bacteremic UTI who may benefit from longer courses of parenteral antibiotic therapy," concluded the authors.

The bottom line of the study is -- Short-course parenteral therapy with early conversion to oral antibiotics may be considered in infants with bacteremic UTI.