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 studies2- 4 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?
Marquez L, Palazzi DL. Antibiotic Treatment for Febrile Urinary Tract InfectionThe Clock Is Ticking. JAMA Pediatr. 2016;170(9):834-835. doi:10.1001/jamapediatrics.2016.1562