Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\25824181
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Br+J+Gen+Pract
2015 ; 65
(633
): e217-23
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Childhood urinary tract infection in primary care: a prospective observational
study of prevalence, diagnosis, treatment, and recovery
#MMPMID25824181
Butler CC
; O'Brien K
; Pickles T
; Hood K
; Wootton M
; Howe R
; Waldron CA
; Thomas-Jones E
; Hollingworth W
; Little P
; Van Der Voort J
; Dudley J
; Rumsby K
; Downing H
; Harman K
; Hay AD
Br J Gen Pract
2015[Apr]; 65
(633
): e217-23
PMID25824181
show ga
BACKGROUND: The prevalence of targeted and serendipitous treatment for, and
associated recovery from, urinary tract infection (UTI) in pre-school children is
unknown. AIM: To determine the frequency and suspicion of UTI in children who are
acutely ill, along with details of antibiotic prescribing, its appropriateness,
and whether that appropriateness impacted on symptom improvement and recovery.
DESIGN AND SETTING: Prospective observational cohort study in primary care sites
in urban and rural areas in England and Wales. METHOD: Systematic urine sampling
from children aged <5 years presenting in primary care with acute illness with
culture in NHS laboratories. RESULTS: Of 6079 children's urine samples, 339
(5.6%) met laboratory criteria for UTI and 162 (47.9%) were prescribed
antibiotics at the initial consultation. In total, 576/7101 (8.1%) children were
suspected of having a UTI prior to urine sampling, including 107 of the 338 with
a UTI (clinician sensitivity 31.7%). Children with a laboratory-diagnosed UTI
were more likely to be prescribed antibiotics when UTI was clinically suspected
than when it was not (86.0% versus 30.3%, P<0.001). Of 231 children with
unsuspected UTI, 70 (30.3%) received serendipitous antibiotics (that is,
antibiotics prescribed for a different reason). Overall, 176 (52.1%) children
with confirmed UTI did not receive any initial antibiotic. Organism sensitivity
to the prescribed antibiotic was higher when UTI was suspected than when treated
serendipitously (77.1% versus 26.0%; P<0.001). Children with UTI prescribed
appropriate antibiotics at the initial consultation improved a little sooner than
those with a UTI who were not prescribed appropriate antibiotics initially (3.5
days versus 4.0 days; P = 0.005). CONCLUSION: Over half of children with UTI on
culture were not prescribed antibiotics at first presentation. Serendipitous UTI
treatment was relatively common, but often inappropriate to the organism's
sensitivity. Methods for improved targeting of antibiotic treatment in children
who are acutely unwell are urgently needed.
|*Primary Health Care/methods/standards/statistics & numerical data
[MESH]