Management of urinary tract infections in children: evaluation of clinical practice

Bontemps, S.; Lagree, Marion; Dessein, Rodrigue; Maftei, A.; Martinot, Alain; Dubos, Francois

Document type :

Article dans une revue scientifique: Article original

DOI :

10.1016/j.arcped.2014.10.005

PMID :

25482995

Permalink :

http://hdl.handle.net/20.500.12210/16915

Title :

Management of urinary tract infections in children: evaluation of clinical practice

Author(s) :

Bontemps, S. [Auteur]
Lagree, Marion [Auteur]
Dessein, Rodrigue [Auteur]

Recherche translationelle relations hôte-pathogènes
Recherche translationelle relations hôte-pathogènes
Maftei, A. [Auteur]
Martinot, Alain [Auteur]

Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Dubos, Francois [Auteur]

Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]

Journal title :

Archives de pediatrie . organe officiel de la Societe francaise de pediatrie

Abbreviated title :

Arch. Pediatr.

Volume number :

Pages :

24-31

Publication date :

2015-01-01

ISSN :

0929-693X

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE: To determine the rate of therapeutic management satisfying the institutional protocol for children with urinary tract infection (UTI) in the context of the emergence of extended-spectrum beta-lactamase ...
Show more >OBJECTIVE: To determine the rate of therapeutic management satisfying the institutional protocol for children with urinary tract infection (UTI) in the context of the emergence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. METHODS: A retrospective, single-center, observational study was carried out for 1 year (2010-2011). Data from all children admitted to the emergency department with a diagnosis of UTI were analysed. Adherence to the protocol was evaluated for the initial management and at re-evaluation with the definitive result of the urine culture. Risk factors for nonadherence were analysed. RESULTS: Among the children, 393 were included. An ESBL Enterobacteriaceae-related UTI was identified in 2.2% of urine analyses. The initial therapeutic management satisfied the protocol for 95% of children and at re-evaluation for 80%. Nonadherence was related to poorly adapted treatment (59%) and an erroneous indication of dual antibiotic therapy (20%). Variables associated with the inadequacy of the initial management were age less than 3 months (adjusted OR [aOR]: 9.3; 95%CI: 3.5-24.8) and at re-evaluation age under 3 months (aOR: 12.8; 95%CI: 5.5-29.9) and an unconfirmed infection in the final urine culture (aOR: 30.8; 14.7-64.3). CONCLUSIONS: Adherence to the protocol was good but could be increased by a better re-evaluation procedure with the result of the urine culture. ESBL Enterobacteriaceae-related UTIs were still rare enough to influence the efficacy of management.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

Submission date :

2019-12-09T16:51:04Z

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