Abstract
Although urinary tract infections are of particular concern in young children, as they may lead to permanent health problems, there is no consensus for their acute management. We carried out a mailed survey of 455 general practitioners, 143 paediatricians (randomly selected from a list of physicians in the Rhône-Alpes region of France) and 45 paediatric nephrologists (all the members of the “Société de Néphrologie Pédiatrique”) to examine their attitudes to the management of a fictious case of a young girl with symptoms indicative of acute pyelonephritis. The responses given by the general practitioners and paediatricians were similar, whereas those given by the paediatric nephrologists were often different, for example 20% of the general practitioners and 17% of the paediatricians said they would hospitalise the child, compared with 69% of the paediatric nephrologists. The majority of the general practitioners and paediatricians favoured single oral antibiotic therapy, whereas the paediatric nephrologists were split between single and combined antibiotic therapy, but preferred intravenous administration. The most frequently prescribed drug was a penicillin. The heterogeneity of the results from this survey stresses the need for the assessment of various strategies in terms of their efficacy for preventing kidney scarring and their risk-to-benefit ratios in well-designed randomised controlled trials.
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References
Jodal U, Winberg J (1987) Pyelonephritis. Report of the 4th International Symposium, Göteborg, Sweden, 1986. Pediatr Nephrol 1: 248–252
Koff SA (1991) A practical approach to evaluating urinary tract infections in children. Pediatr Nephrol 5: 398–400
Jacobson SH, Eklöf O, Eriksson CG, Lins LE, Tidgren B, Winberg J (1989) Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up. BMJ 299: 703–706
White RHR (1990) Management of urinary tract infection and vesicoureteric reflux in children. I. Operative treatment has no advantage over medical management. BMJ 300: 1391–1392
O'Donnel B (1990) Management of urinary tract infection and vesicoureteric reflux in children. II. The case for surgery. BMJ 300: 1393–1394
South Bedfordshire Practitioners' Group (1990) Development of renal scars in children: missed opportunities in management. BMJ 301: 1082–1084
Bensman A (1991) Conférence de consensus en thérapeutique anti-infectieuse (16–18 November 1990): antibiothérapie des infections urinaires. Le traitement de la pyélonéphrite aiguë de l'enfant. Arch Fr Pediatr: 229–232
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“Groupe d'Etude de la Prescription” (Prescription Study Group): Serge Barry, Jean-Pierre, Philippe Cialdella, Serge Ferry, Vincent Sciortino
“Groupe d'Etude de la Prescription” (Prescription Study Group): Serge Barry, Jean-Pierre, Philippe Cialdella, Serge Ferry, Vincent Sciortino
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Cornn, C., Cochat, P., Collet, JP. et al. Survey of the attitudes to management of acute pyelonephritis in children. Pediatr Nephrol 8, 275–277 (1994). https://doi.org/10.1007/BF00866331
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DOI: https://doi.org/10.1007/BF00866331