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. 2024 Jun;29(3):316-322.
doi: 10.5863/1551-6776-29.3.316. Epub 2024 Jun 10.

Association Between Antibiotic Duration and Recurrence of Urinary Tract Infection in the Neonatal Critical Care Unit

Kimberly Van  1 , Priyanka H Patel  1 , Kristen Jones  1 , Christopher Jackson  1 , Najla Faddoul  1 , Anoop Pulickal  1
Affiliations

Association Between Antibiotic Duration and Recurrence of Urinary Tract Infection in the Neonatal Critical Care Unit

Kimberly Van et al. J Pediatr Pharmacol Ther. 2024 Jun.

Abstract

Objectives: Urinary tract infection (UTI) is the most common bacterial infection in infants. Current practice guidelines suggest a treatment duration of 7 to 14 days. Suboptimal therapy may increase the risk for recurrent UTIs leading to renal scarring and possibly chronic kidney disease. The primary objective is to evaluate the duration of therapy for UTIs and its association with the incidence of recurrent UTIs in a neonatal intensive care unit (NICU). The secondary objectives are to identify the risk factors and the most common organisms for recurrent UTIs.

Methods: Patients were identified via the diagnosis codes for UTIs and were included if admitted to the NICU and if they received antibiotics prior to hospital discharge. Patients were divided into 2 groups: antibiotic treatment for 7 days or fewer and antibiotic treatment for greater than 7 days.

Results: Eighty-six infants were included in the study. Twenty-six patients received antibiotics for 7 days or fewer, and 60 for more than 7 days. In the study, the median birth weight was 977 g and the median gestational age was 27.6 weeks. There was no significant difference in the rate of recurrent UTIs between the 2 groups (p = 0.66). However, in the subgroup analysis, the incidence was higher for patients receiving antibiotic therapy for fewer than 7 days versus 7 days (p = 0.03).

Conclusion: There was no difference in recurrence of UTI between treatment groups (≤7 days versus >7 days), and recurrence was seen in a higher percentage of patients with a urinary tract anomaly.

Keywords: antibiotic; duration of therapy; neonatal infection; pyelonephritis; recurrent urinary tract infection.

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Conflict of interest statement

Disclosure. The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria. All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Figures

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Figure.
Organisms from first urine culture.
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