When an infant is hospitalized with a urinary tract infection (UTI), intravenous (IV) therapy is usually initiated. But how long should you use IV before changing over to a per oral (PO) antibiotic? To answer that question, Lewis de Los Angeles et al. (10.1542/peds.2017-1021) share the results of a retrospective analysis of infants less than 60 days who were diagnosed and admitted at 46 free-standing children’s hospitals from 2005-2015 to see if readmissions occurred and whether those readmissions were associated with a shorter duration of IV therapy. The authors analyzed data using trends in duration of IV antibiotic usage from 2005 to 2015. The good news is that the proportion of infants who got 4 or more days of IV antibiotics decreased from 50% to 19% from 2005 to 2015. In fact there was no correlation over the period studied between duration of antibiotics and readmissions suggesting using a shorter course of IV antibiotics.
So how long do you treat an infant with a UTI with IV antibiotics? Do you go with the IV flow for at least four or more days, or do you move from IV to PO in the shortest time period possible—and at what cost? Will this article change how you practice? We’d love to hear your take on this study relative to what you do in your own practice by responding to this blog, posting a comment on our website, or sharing your thoughts on our Facebook or Twitter sites.