Cochrane · systematic review · CD003772
Antibiotics for acute pyelonephritis in children
Strohmeier, Y, Hodson, EM, Willis, NS, et al. · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
13
current version
GRADE rated
13
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 7 · 53.8%Moderate 6 · 46.2%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Oral versus IV followed by oral (11 days) therapy for acute pyelonephritis in children
Population: children with acute pyelonephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to fever resolution (hours) Oral vs IV followed by oral (11 days) therapy | no estimate extracted | 2 studies · 808 participants | Moderate Downgraded: imprecision |
Renal parenchymal damage at 6 to 12 months: all included children with acute pyelonephritis DMSA scans Oral vs IV followed by oral (11 days) therapy | RR 0.82 [0.59, 1.12] | 4 studies · 943 participants | Moderate |
Renal parenchymal damage at 6 to 12 months: children with renal parenchymal damage on initial DMSA Oral vs IV followed by oral (11 days) therapy | RR 0.79 [0.61, 1.03] | 4 studies · 681 participants | Moderate |
Short duration (3 to 4 days) versus long duration (7 to 14 days) IV therapy for acute pyelonephritis in children
Population: children with acute pyelonephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent bacteriuria after treatment Short duration (3 to 4 days) vs long duration (7 to 14 days) IV therapy | RR 0.78 [0.24, 2.55] | 4 studies · 305 participants | Low Downgraded: risk of bias, imprecision |
Recurrent UTI within 6 months Short duration (3 to 4 days) vs long duration (7 to 14 days) IV therapy | RR 0.97 [0.58, 1.62] | 5 studies · 993 participants | Moderate Downgraded: risk of bias |
Persistent renal damage at 3 to 6 months: all included children with acute pyelonephritis Short duration (3 to 4 days) vs long duration (7 to 14 days) IV therapy | RR 1.01 [0.8, 1.29] | 4 studies · 726 participants | Moderate Downgraded: risk of bias |
Persistent renal damage at 3 to 6 months: children with initial renal parenchymal damage on initial DMSA scan Short duration (3 to 4 days) vs long duration (7 to 14 days) IV therapy | RR 1.1 [0.84, 1.45] | 3 studies · 315 participants | Moderate Downgraded: risk of bias |
Different dosing regimens of aminoglycosides (daily versus 8 hourly) for acute pyelonephritis in children
Population: children with acute pyelonephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent bacteriuria after 1 to 3 days of treatment Different dosing regimens of aminoglycosides (daily vs 8 hourly) | RR 1.05 [0.15, 7.27] | 3 studies · 435 participants | Low Downgraded: risk of bias, imprecision |
Hearing impairment following treatment Different dosing regimens of aminoglycosides (daily vs 8 hourly) | RR 2.83 [0.33, 24.56] | 3 studies · 271 participants | Low Downgraded: risk of bias, imprecision |
Increase in serum creatinine during treatment Different dosing regimens of aminoglycosides (daily vs 8 hourly) | RR 0.75 [0.2, 2.82] | 3 studies · 419 participants | Low Downgraded: risk of bias, imprecision |
Agent: Third generation cephalosporin versus other antibiotic for acute pyelonephritis in children
Population: children with acute pyelonephritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent bacteriuria Agent: Third generation cephalosporin vs other antibiotic | RR 2.41 [0.98, 5.93] | 3 studies · 439 participants | Low Downgraded: risk of bias, imprecision |
Recurrent UTI after end of therapy Agent: Third generation cephalosporin vs other antibiotic | RR 1.23 [0.32, 4.74] | 4 studies · 491 participants | Low Downgraded: risk of bias, imprecision |
Persistent symptoms after end of treatment Agent: Third generation cephalosporin vs other antibiotic | RR 0.28 [0.13, 0.62] | 3 studies · 471 participants | Low Downgraded: risk of bias, inconsistency |