Evaluation of Short-Term Antibiotic Therapy in Children with Uncomplicated Urinary Tract Infections

Abstract

This study was designed to determine whether serum C-reactive protein (CRP) concentrations could be used to identify children with uncomplicated lower urinary tract infection [bacterial] who would respond favorably to short-term antibiotic therapy. A 1-day or 10-day regimen of cefadroxil (30 mg/kg per day in 2 divided doses) was assigned randomly to 80 children who had acute urinary tract infection and CRP concentrations < 28 .mu.g/ml (CRP-negative group). Ten days of cefadroxil therapy was used to treat 44 children with urinary tract infection and CRP values .ltoreq. 28 .mu.g/ml (CRP-positive group). The clinical and laboratory characteristics of the children in the 2 CRP-negative therapy groups were similar to, but different from those of children with CRP-positive infections. Recurrent infections occurred significantly more often at 4-5 days after completion of therapy in CRP-negative children who recieved 1 day (44.4%) compared 10 days (20%) of cefadroxil therapy (P < 0.05). When data from this study were combined with those from a previously published investigation of short-term antibiotic therapy in CRP-negative children, a significantly larger percentage of recurrences was documented immediately after 1 or 4 days of antibiotics (79%) compared to recurrences after the standard ten-day regimen (41%). The total rate of recurrent infections for all children in both studies was significantly larger in those who received short-term therapy (48%) as opposed to conventional therapy (34%). These data indicate that short-term antibiotic therapy is less effective than the conventional 10 day regimen in children with CRP-negative urinary tract infection.