3 Jul 2023 • Shorter antibiotic treatment didn't measure up for children with urinary tract infection (UTI), the SCOUT trial found. Stopping antibiotics when symptoms improved after an initial 5-day course yielded a 4.1% rate of persistent symptomatic UTI by follow-up at day 11-14 compared with 0.6% when kids had the full 10-day course, Dr. Nader Shaikh of the Children's Hospital of Pittsburgh, and colleagues reported.

However, the failure rate of short-course therapy was still low enough to suggest it could be considered as a reasonable option for kids exhibiting clinical improvement after 5 days of antimicrobial treatment, the researchers wrote in JAMA Pediatrics

• The SCOUT (Short Course Therapy for Urinary Tract Infections) noninferiority trial was conducted at outpatient clinics and emergency departments at two children's hospitals from May 2012 through August 2019.
• Participants included children ages 2 months to 10 years with UTI exhibiting clinical improvement after 5 days of antimicrobial therapy.
• The trial randomized 664 children (median age 4 years) to an additional 5 days of antibiotics or placebo.
• Children receiving short-course therapy were more likely to have asymptomatic bacteriuria or a positive urine culture at or by the first follow-up visit
• There were no differences in rates of UTI, adverse events or antimicrobial resistance between the two groups after that visit, the researchers reported.

“[The results] were surprising because almost nobody failed in either group,” Dr Shaikh said. “Less than 5% of people failed in both arms, so to me that says either one works pretty well — better than we thought.”

Source: JAMA Pediatrics | Read full story