Abstract | OBJECTIVE: The objective was to compare the efficacies of single-dose, short-course (4 days or less), and standard course (5 days or greater) antimicrobial therapy for uncomplicated childhood cystitis. METHODS: Prospective, randomized, controlled trials comparing 4 days or less of therapy (short courses) with 5 days or more of therapy (conventional therapy) were included if all of the subjects were <18 years of age, the initial infection was documented by urine culture, at least 1 subsequent culture was obtained between 3 and 30 days of enrollment, and some attempt was made to separate upper tract from lower tract infection. Composite differences among treatment groups were compared with a fixed or random effects model, depending on the test for heterogeneity. RESULTS: Of the 517 citations identified by literature search, 37 were selected for detailed review, and 22 were included in the final meta-analysis. The overall difference in cure rates between short and conventional courses of therapy was significant (6.38%; 95% CI: 1.88% to 10.89%), favoring the conventional course. Similar results were obtained when only studies comparing the same agents in the short and conventional courses were included (7.92%; 95% CI: 2.09% to 13.8%). Short-course amoxicillin was inferior to conventional length course (difference in cure rate, 13%; 95% CI: 4% to 24%); no difference was found between short-course and conventional length courses of trimethoprim-sulfamethoxazole (difference in cure rate, 6.24%; 95% CI = -3.74% to 16.2%). CONCLUSIONS:
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Authors | D Tran, D G Muchant, S C Aronoff |
Journal | The Journal of pediatrics
(J Pediatr)
Vol. 139
Issue 1
Pg. 93-9
(Jul 2001)
ISSN: 0022-3476 [Print] United States |
PMID | 11445800
(Publication Type: Journal Article, Meta-Analysis)
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Chemical References |
- Anti-Infective Agents, Urinary
- Penicillins
- Amoxicillin
- Trimethoprim, Sulfamethoxazole Drug Combination
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Topics |
- Adolescent
- Amoxicillin
(therapeutic use)
- Anti-Infective Agents, Urinary
(therapeutic use)
- Child
- Child, Preschool
- Cystitis
(drug therapy)
- Drug Administration Schedule
- Humans
- Infant
- Penicillins
(therapeutic use)
- Time Factors
- Trimethoprim, Sulfamethoxazole Drug Combination
(therapeutic use)
- Urinary Tract Infections
(drug therapy)
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