Although antibiotic treatment is effective for children with UTI, there are insufficient data to answer the question of which type of antibiotic or which duration is most effective to treat symptomatic lower UTI. This review found that 10-day antibiotic treatment is more likely to eliminate bacteria from the urine than single-dose treatments. No differences were observed for persistent bacteriuria, recurrence or re-infection between short and long-course antibiotics where the antibiotic differed between groups. This data adds to an existing Cochrane review comparing short and long-course treatment of the same antibiotic who also reported no evidence of difference between short and long-course antibiotics.
Single-dose amoxicillin therapy of uncomplicated pediatric urinary tract infections.
Forty-nine ambulatory children between 2-1/2 and 12 years of age with acute, clinically uncomplicated urinary tract infections caused by susceptible organisms were randomized to receive a single dose of amoxicillin based on weight or a 10-day course of amoxicillin therapy (conventional therapy). Patients receiving single doses of amoxicillin had a cure rate of 63%, which compares unfavorably with the cure rate of 92% in patients given conventional therapy. A failure of single-dose therapy predicted underlying radiologic abnormalities with a sensitivity of 60% and a specificity of 58%, making it a poor screening test for detecting those patients at risk for renal parenchymal damage. The antibody-coated bacteria assay had no predictive value in separating upper and lower tract disease, although it may predict underlying radiologic abnormalities. The data indicate that the response to single-dose amoxicillin therapy fails to separate upper from lower tract disease reliably and has a limited role in predicting response to conventional antimicrobial therapy.