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Similar treatment given for UTI, despite diagnosis criteria

SAN FRANCISCO — Children who met the diagnostic criteria for a urinary tract infection received similar treatment to those who did not, according to study findings presented here.

The study included 201 infants aged 1 to 24 months discharged from the hospital with a primary diagnosis of UTI between Sept. 1, 2007 and Sept. 1, 2011. Overall, 55.7% of participants were male and 46.3% were aged 2 to 24 months.

More than half of the infants had a fever (54.2%) and 66.7% had one uropathogen present. Sixty-two percent of patients had >5 white blood cells per high-field power, 26.1% had positive urinary nitrates and 67.9% have positive leukocyte esterase. Mean days of hospitalization for patients who met diagnostic criteria was 4.8 days compared with 5 days for those who did not meet criteria. Mean days of antimicrobials for patients who met diagnostic criteria were 9.1 days compared with 8.4 days for those who did not meet criteria. However, regardless of diagnostic criteria, most patients underwent ultrasound, blood culture and voiding cystourethrogram.

“By consistently applying diagnostic criteria, we could have potentially avoided 1,611 days of antimicrobials and 655 days of hospitalization,” the researchers wrote. “This represents an important opportunity for [antimicrobial stewardship] in a pediatric hospital setting.”

For more information:

Le Saux N. Abstract #874. Presented at: ID Week 2013; Oct. 2-6, 2013; San Francisco.

Disclosure: The researchers report no relevant financial disclosures.