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September 2016

Antibiotic Treatment for Febrile Urinary Tract InfectionThe Clock Is Ticking

Author Affiliations
  • 1Section of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas
JAMA Pediatr. 2016;170(9):834-835. doi:10.1001/jamapediatrics.2016.1562

In this issue of JAMA Pediatrics, Shaikh et al1 report that early antibiotic treatment was associated with decreased risk of renal scarring in children with a first or second febrile urinary tract infection (UTI). The authors found that in children with renal scarring, the median duration of fever prior to starting antibiotics was 72 hours vs 48 hours in those without scarring. Delay in treatment remained significantly associated with scarring even after adjusting for confounders such as age, race/ethnicity, and interim UTIs. These findings complement several published studies24 that stress the importance of timely antibiotic administration for UTI. So who were the patients included in this study, and what do the findings mean for physicians evaluating children for UTI?

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