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A Methodological Review of the Literature

Michael Moffatt, MD, FRCP(C); Joanne Embree, MD, FRCP(C); Paul Grimm, MD; Barbara Law, MD, FRCP(C)

Am J Dis Child. 1988;142(1):57-61.

Abstract
• We performed a methodological review of 14 published clinical trials of short-course (4 days) vs conventional (seven to ten days) antibiotic therapy for urinary tract infection in children. Four reviewers independently assessed each study, without knowledge of authorship, according to 35 criteria, 14 of which were considered critical for this type of study. Reviewer ratings were summed so that any study could receive a potential score of 140 for all criteria and 56 for the critical criteria. Only one study met more than 75% of all the criteria, whereas four studies met 75% of critical criteria. Two studies found short-course antibiotic therapy significantly less effective than conventional therapy. The remaining 12 had insufficient sample size to warrant the conclusion that the two therapies were equivalent. We conclude that there is insufficient evidence to warrant the use of short-course antibiotic therapy for urinary tract infection in children and that a much larger study, with attention to some of the details described, is warranted.

(AJDC 1988;142:57-61)

Author Affiliations
From the Department of Pediatrics, Section of Infectious Diseases, and Division of Community and Northern Medicine, University of Manitoba, Winnipeg. Dr Embree is now with the Department of Medical Microbiology, University of Nairobi, Kenya, East Africa, and Dr Grimm is now with Izaak Walton Killam Hospital for Children, Halifax, Nova Scotia.

Footnotes
Accepted for publication June 18, 1987.

Reprint requests to the Division of Community and Northern Medicine, University of Manitoba, 61 Emily St, Winnipeg, Manitoba, Canada R3E 1Y9 (Dr Moffatt).

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