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Children with acute pyelonephritis need medical re-evaluation when home-treated with oral antibiotics

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Harvard

Sehested, LT, Kamperis, K, Winding, L, Bjerre, CK, Neland, M, Hagstrøm, S, Wilms, LK, Andersen, MLE, Kuhne-Qvist, L, Hoffmann-Petersen, JS, Nørgaard, H & Cortes, D 2021, 'Children with acute pyelonephritis need medical re-evaluation when home-treated with oral antibiotics', Acta paediatrica, vol. 110, no. 9, 15958, pp. 2627-2634. https://doi.org/10.1111/apa.15958

APA

Sehested, L. T., Kamperis, K., Winding, L., Bjerre, C. K., Neland, M., Hagstrøm, S., Wilms, L. K., Andersen, M. L. E., Kuhne-Qvist, L., Hoffmann-Petersen, J. S., Nørgaard, H., & Cortes, D. (2021). Children with acute pyelonephritis need medical re-evaluation when home-treated with oral antibiotics. Acta paediatrica, 110(9), 2627-2634. [15958]. https://doi.org/10.1111/apa.15958

CBE

Sehested LT, Kamperis K, Winding L, Bjerre CK, Neland M, Hagstrøm S, Wilms LK, Andersen MLE, Kuhne-Qvist L, Hoffmann-Petersen JS, Nørgaard H, Cortes D. 2021. Children with acute pyelonephritis need medical re-evaluation when home-treated with oral antibiotics. Acta paediatrica. 110(9):2627-2634. https://doi.org/10.1111/apa.15958

MLA

Vancouver

Sehested LT, Kamperis K, Winding L, Bjerre CK, Neland M, Hagstrøm S et al. Children with acute pyelonephritis need medical re-evaluation when home-treated with oral antibiotics. Acta paediatrica. 2021 Sep;110(9):2627-2634. 15958. https://doi.org/10.1111/apa.15958

Author

Sehested, Line Thousig ; Kamperis, Konstantinos ; Winding, Louise ; Bjerre, Charlotte Kjaer ; Neland, Mette ; Hagstrøm, Søren ; Wilms, Line Kønig ; Andersen, Marie Louise Elkjaer ; Kuhne-Qvist, Linda ; Hoffmann-Petersen, Jette Skjøde ; Nørgaard, Hanne ; Cortes, Dina. / Children with acute pyelonephritis need medical re-evaluation when home-treated with oral antibiotics. In: Acta paediatrica. 2021 ; Vol. 110, No. 9. pp. 2627-2634.

Bibtex

@article{bb55ba16914e4c3bab62fbbdd31c206e,
title = "Children with acute pyelonephritis need medical re-evaluation when home-treated with oral antibiotics",
abstract = "Aim: To investigate the efficacy and safety of home-treatment with oral piv-mecillinam or amoxicillin-clavulanate in children with acute pyelonephritis. Methods: Children aged over 6 months diagnosed with culture confirmed pyelonephritis at Danish Paediatric Departments were home-treated with piv-mecillinam (tablets) or amoxicillin-clavulanate (liquid or tablets). Follow-up was performed by phone (second treatment day) and clinical review of the patients in the hospital (day three). Results: Four hundred eighteen children were included. In total, 333/418 (80%) responded well to the initial oral antibiotic treatment. 85/418 (20%) were changed to another treatment of these 47/418 (11%) to a second-line oral antibiotic and 38/418 (9%) to intravenous antibiotics due to insufficient clinical improvement or bacterial resistance. Bacterial resistance was similar for piv-mecillinam and amoxicillin-clavulanate: 4/74 (5%) versus 33/333 (10%) (p = 0.22). Insufficient clinical improvement, despite no resistance, primarily occurred in children treated with piv-mecillinam: 16/74 (22%) versus 28/344 (8%) (p < 0.001), and predominantly occurred in piv-mecillinam treated children <5 years: 7/20 (35%) versus 9/54 (17%) (p < 0.05), potentially because of problems with piv-mecillinam tablets. In the study population no cases of death or septicemia developed after start of initial oral treatment. Conclusion: A home-treatment regime for pyelonephritis in children >6 months is safe; however, during treatment, clinical re-evaluation is required as in 20% of cases a change in treatment was necessary.",
keywords = "amoxicillin-clavulanate, home-treatment, paediatrics, piv-mecillinam, pyelonephritis",
author = "Sehested, {Line Thousig} and Konstantinos Kamperis and Louise Winding and Bjerre, {Charlotte Kjaer} and Mette Neland and S{\o}ren Hagstr{\o}m and Wilms, {Line K{\o}nig} and Andersen, {Marie Louise Elkjaer} and Linda Kuhne-Qvist and Hoffmann-Petersen, {Jette Skj{\o}de} and Hanne N{\o}rgaard and Dina Cortes",
note = "Publisher Copyright: {\textcopyright} 2021 Foundation Acta P{\ae}diatrica. Published by John Wiley & Sons Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = sep,
doi = "10.1111/apa.15958",
language = "English",
volume = "110",
pages = "2627--2634",
journal = "Acta paediatrica",
issn = "1651-2227",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "9",

}

RIS

TY - JOUR

T1 - Children with acute pyelonephritis need medical re-evaluation when home-treated with oral antibiotics

AU - Sehested, Line Thousig

AU - Kamperis, Konstantinos

AU - Winding, Louise

AU - Bjerre, Charlotte Kjaer

AU - Neland, Mette

AU - Hagstrøm, Søren

AU - Wilms, Line Kønig

AU - Andersen, Marie Louise Elkjaer

AU - Kuhne-Qvist, Linda

AU - Hoffmann-Petersen, Jette Skjøde

AU - Nørgaard, Hanne

AU - Cortes, Dina

N1 - Publisher Copyright: © 2021 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/9

Y1 - 2021/9

N2 - Aim: To investigate the efficacy and safety of home-treatment with oral piv-mecillinam or amoxicillin-clavulanate in children with acute pyelonephritis. Methods: Children aged over 6 months diagnosed with culture confirmed pyelonephritis at Danish Paediatric Departments were home-treated with piv-mecillinam (tablets) or amoxicillin-clavulanate (liquid or tablets). Follow-up was performed by phone (second treatment day) and clinical review of the patients in the hospital (day three). Results: Four hundred eighteen children were included. In total, 333/418 (80%) responded well to the initial oral antibiotic treatment. 85/418 (20%) were changed to another treatment of these 47/418 (11%) to a second-line oral antibiotic and 38/418 (9%) to intravenous antibiotics due to insufficient clinical improvement or bacterial resistance. Bacterial resistance was similar for piv-mecillinam and amoxicillin-clavulanate: 4/74 (5%) versus 33/333 (10%) (p = 0.22). Insufficient clinical improvement, despite no resistance, primarily occurred in children treated with piv-mecillinam: 16/74 (22%) versus 28/344 (8%) (p < 0.001), and predominantly occurred in piv-mecillinam treated children <5 years: 7/20 (35%) versus 9/54 (17%) (p < 0.05), potentially because of problems with piv-mecillinam tablets. In the study population no cases of death or septicemia developed after start of initial oral treatment. Conclusion: A home-treatment regime for pyelonephritis in children >6 months is safe; however, during treatment, clinical re-evaluation is required as in 20% of cases a change in treatment was necessary.

AB - Aim: To investigate the efficacy and safety of home-treatment with oral piv-mecillinam or amoxicillin-clavulanate in children with acute pyelonephritis. Methods: Children aged over 6 months diagnosed with culture confirmed pyelonephritis at Danish Paediatric Departments were home-treated with piv-mecillinam (tablets) or amoxicillin-clavulanate (liquid or tablets). Follow-up was performed by phone (second treatment day) and clinical review of the patients in the hospital (day three). Results: Four hundred eighteen children were included. In total, 333/418 (80%) responded well to the initial oral antibiotic treatment. 85/418 (20%) were changed to another treatment of these 47/418 (11%) to a second-line oral antibiotic and 38/418 (9%) to intravenous antibiotics due to insufficient clinical improvement or bacterial resistance. Bacterial resistance was similar for piv-mecillinam and amoxicillin-clavulanate: 4/74 (5%) versus 33/333 (10%) (p = 0.22). Insufficient clinical improvement, despite no resistance, primarily occurred in children treated with piv-mecillinam: 16/74 (22%) versus 28/344 (8%) (p < 0.001), and predominantly occurred in piv-mecillinam treated children <5 years: 7/20 (35%) versus 9/54 (17%) (p < 0.05), potentially because of problems with piv-mecillinam tablets. In the study population no cases of death or septicemia developed after start of initial oral treatment. Conclusion: A home-treatment regime for pyelonephritis in children >6 months is safe; however, during treatment, clinical re-evaluation is required as in 20% of cases a change in treatment was necessary.

KW - amoxicillin-clavulanate

KW - home-treatment

KW - paediatrics

KW - piv-mecillinam

KW - pyelonephritis

UR - http://www.scopus.com/inward/record.url?scp=85107778277&partnerID=8YFLogxK

U2 - 10.1111/apa.15958

DO - 10.1111/apa.15958

M3 - Journal article

C2 - 34050973

VL - 110

SP - 2627

EP - 2634

JO - Acta paediatrica

JF - Acta paediatrica

SN - 1651-2227

IS - 9

M1 - 15958

ER -

ID: 65944780