Methodology: 3.5/5
Usefulness: 2.5/5
Montini G, et al. Pediatrics. 2024 Jan 1;153(1):e2023062598.
Question and Methods: This multicenter, parallel-group randomized controlled trial intended to determine the non-inferiority of a 5-day versus 10-day course of oral clavulin for treating of febrile urinary tract infections (fUTI) in children.
Findings: The primary outcome of recurrence of UTI within 30 days was found in 2.8% (2/27) in the short-course group and 14.3% (10/70) in the standard-course group (ARR -11.51% (95% CI, -20.52 to -2.47), supporting the noninferiority of a 5-day treatment.
Limitations: Limitations of this study include its unblinded nature, underpowered sample size due to early termination of the study.
Interpretation: While it is likely safe to treat uncomplicated febrile urinary tract infections with shorter courses of antibiotics, until further conclusive evidence is available, clinicians should follow national guidelines (ex. TREKK) which currently recommend a 7-day course of antibiotics in uncomplicated fUTI.
JC Supervisor: Dr. Ian Stiell
