Short-course antibiotic therapy for urinary tract infections in children. A methodological review of the literature
M. Moffatt, J. Embree, P. Grimm and B. Law
Department of Pediatrics, University of Manitoba, Winnipeg, Canada.
We performed a methodological review of 14 published clinical trials of
short-course (less than or equal to 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.
