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Urinary Tract Infection in Young Infants: Practice Patterns in Evaluation and Treatment. Hosp Pediatr 2020 Sep;10(9):792-796

Date

08/21/2020

Pubmed ID

32817064

DOI

10.1542/hpeds.2020-0178

Scopus ID

2-s2.0-85139099991 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

OBJECTIVES: No clear guidelines exist for the management of infants ≤60 days old with urinary tract infection (UTI), although this condition represents a significant percentage of serious bacterial infection in this age group. We examined patterns of UTI management in infants ≤60 days at a tertiary care children's hospital and hypothesized that younger infants would be hospitalized longer.

METHODS: We reviewed electronic health records of infants age ≤60 days with diagnostic codes of UTI or fever hospitalized from January 2013 to January 2017 with urine culture obtained and UTI diagnosis documented. Outcomes were duration of parenteral antibiotic therapy, length of stay (LOS), and hospital readmission.

RESULTS: One hundred ninety-three infants met criteria. Median age at admission was 37 days (interquartile range [IQR]: 22-48). Median duration of parenteral antibiotics was 59 hours (IQR 43-114) and median LOS was 71 hours (IQR 57 127). Infants age ≤28 days, with fever duration ≥24 hours, irritability or lethargy on initial examination, and bacteremia received longer parenteral therapy and had longer LOS. In multivariate analysis, age, irritability or lethargy, and presence of bacteremia remained independently related to parenteral therapy duration and LOS.

CONCLUSIONS: In young infants with UTI, patients aged ≤28 days had longer duration of IV antibiotic therapy and LOS, independent of other clinical characteristics of their illness. The duration of parenteral therapy and LOS was relatively short, although significant variability still existed.

Author List

Swartz S, Kolinski J, Hadjiev J, Chou E, Malone C, Zhang J, Yan K, Havens P

Authors

Erica Y. Chou MD Director, Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Jennifer M. Hadjiev MD Chief, Associate Professor in the Pediatrics department at Medical College of Wisconsin
Julie M. Kolinski MD Associate Professor in the Medicine department at Medical College of Wisconsin
Sheila Swartz MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Ke Yan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Anti-Bacterial Agents
Bacteremia
Bacterial Infections
Child
Fever
Humans
Infant
Retrospective Studies
Urinary Tract Infections