HCPLive Network

Evidence Discredits Aggressive UTI Testing in Young Children

 
MONDAY, Jan. 21 (HealthDay News) -- Guidelines recommending aggressive testing of young children with fevers for urinary tract infections (UTIs) should be revisited given the lack of evidence and long-term justification, according to research published online Jan. 11 in the Annals of Emergency Medicine.

Noting that the American Academy of Pediatrics' guidelines recommend aggressive diagnosis, treatment, and investigation of possible pediatric urinary tract infection in children with fever who are younger than 2 years, David H. Newman, M.D., of the Mount Sinai School of Medicine in New York City, and colleagues reviewed the literature to examine the utility and efficacy of this early identification and treatment. They focused specifically on the utility of antibiotics for reducing delayed renal complications and the utility of timely diagnosis and treatment in prevention of renal scarring.

The researchers found that, although two studies linked aggressive and early identification of urinary tract infection with prevention of long-term renal complications, a more substantive body of evidence did not find evidence for this link. In addition, renal scarring was found to be relatively common, but there was no evidence suggesting that scarring has long-term sequelae.

"Pediatric urinary tract infection in well children does not appear to result in currently identifiable long-term clinical sequelae, and antimicrobial treatment appears unable to affect either intermediary markers such as renal scarring or long-term outcome," the authors write. "Aggressive testing may be more harmful than helpful. An initial observational approach to well children with fever seems reasonable."
 

Abstract
Full Text (subscription or payment may be required)


Copyright © 2013 HealthDay. All rights reserved.
 
 

Further Reading
Researchers at Hong Kong University and the Wellcome Trust Sanger Institute have identified a link between the influenza A viruses’ genetic diversity and severity of the infection.
Carol Burke, MD, FACG, FASGE, talks about her phase-3 placebo-controlled trial of Celecoxib in pediatric subjects with familial adenomatous polyposis (FAP) at the 2014 ACG Annual Meeting in Philadelphia, PA.
Carol Burke, MD, FACG, FASGE, discusses pediatric familial adenomatous polyposis (FAP) and colorectal cancer at the 2014 ACG Annual Scientific Meeting in Philadelphia, PA.
The immune system is the new focus of much work on traumatic brain injury (TBI). In a challenge to the paradigm that the blood brain barrier prevents harmful leukocytes from entering the brain, a Texas team tried to neutralize the impact of these cells. Peripheral lymphocytes are activated after TBI. They may then act as potential antigen presenting cells and get into the brain, causing cells there to degenerate.
Drinking sugar-sweetened sodas may affect cellular aging by shortening telomere length, according to research published online Oct. 16 in the American Journal of Public Health.
Increasing use of hospice in the final days of ovarian cancer does not offset intensive end-of-life care in older women, according to a study published online Oct. 6 in the Journal of Clinical Oncology.
The CDC announces monitoring for all passengers from 3 Ebola-stricken nations, part of increased surveillance efforts as new Ebola czar Ron Klain starts firs day of work. Meanwhile, Bentley, the dog confined because his owner Dallas nurse Nina Pham has the virus, is cleared to go home. NBC medical editor Nancy Snyderman released from her Princeton, NJ home quarantine, and the NBC cameraman stricken with the disease is now Ebola-free.
More Reading