Trial reportBMJ (Clinical research ed.)2003
A nurse led education and direct access service for the management of urinary tract infections in children: prospective controlled trial.
Trial report in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Genetic susceptibility to renal scar formation after urinary tract infection: a systematic review and meta-analysis of candidate gene polymorphisms.Pediatric nephrology (Berlin, Germany) · 2011Pooled it
- Clinical Features for the Diagnosis of Pediatric Urinary Tract Infections: Systematic Review and Meta-Analysis.Annals of family medicinePooled it
- Urinary tract infection guidelines should address unique, specific questions and include analyses of primary data.Pediatric nephrology (Berlin, Germany) · 2024Article
- What's the catch? Urine sample collection from young pre-continent children: a qualitative study in primary care.BJGP open · 2020Article
- Long-term outcomes of urinary tract infection (UTI) in Childhood (LUCI): protocol for an electronic record-linked cohort study.BMJ open · 2019Article
- Improving the Diagnosis and Treatment of Urinary Tract Infection in Young Children in Primary Care: Results from the DUTY Prospective Diagnostic Cohort Study.Annals of family medicine · 2016Article
- Nappy pad urine samples for investigation and treatment of UTI in young children: the 'DUTY' prospective diagnostic cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
- Childhood urinary tract infection in primary care: a prospective observational study of prevalence, diagnosis, treatment, and recovery.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Observational
- Guidelines to identify abnormalities after childhood urinary tract infections: a prospective audit.Archives of disease in childhood · 2014Article
- Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: mixed retrospective and prospective audits.Archives of disease in childhood · 2014Article
- Prevalence of urinary tract infection in acutely unwell children in general practice: a prospective study with systematic urine sampling.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013Observational
- The diagnosis of urinary tract infections in young children (DUTY): protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness.BMC infectious diseases · 2012Article
- Natural history of bilateral mild isolated antenatal hydronephrosis conservatively managed.Pediatric nephrology (Berlin, Germany) · 2012Article
- Vesicoureteral reflux in children with suspected and proven urinary tract infection.Pediatric nephrology (Berlin, Germany) · 2010Article
- Vesicoureteric reflux is not a benign condition.Pediatric nephrology (Berlin, Germany) · 2009Article
- NICE on childhood UTI: Nasty processes produce nasty guidelines.BMJ (Clinical research ed.) · 2007Article
- Management of urinary tract infections in children: no evidence exists.BMJ (Clinical research ed.) · 2003Article
- Management of urinary tract infections in children: priorities need to be set.BMJ (Clinical research ed.) · 2003Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine whether a nurse led education and direct access service improves the care of children with urinary tract infections.
designProspective cluster randomised trial.
settingGeneral practitioners in the catchment area of a UK paediatric nephrology department.
participants88 general practices (346 general practitioners, 107 000 children).
main outcome measuresRate and quality of diagnosis of urinary tract infection, use of prophylactic antibiotics, convenience for families, and the number of infants with vesicoureteric reflux in whom renal scarring may have been prevented.
resultsThe study practices diagnosed twice as many urinary tract infections as the control practices (6.42 v 3.45/1000 children/year; ratio 1.86, 95% confidence interval 1.42 to 2.44); nearly four times more in infants (age < 1 year) and six times more in children without specific symptoms. Diagnoses were made more robustly by study practices than by control practices; 99% v 89% of referred patients had their urine cultured and 79% v 60% had bacteriologically proved urinary tract infections (P < 0.001 for both). Overall, 294 of 312 (94%) children aged under 4 years were prescribed antibiotic prophylaxis by study doctors compared with 61 of 147 (41%) by control doctors (P < 0.001). Study families visited hospital half as much as the control families. Twice as many renal scars were identified in patients attending the study practices. Twelve study infants but no control infants had reflux without scarring.
conclusionA nurse led intervention improved the management of urinary tract infections in children, was valued by doctors and parents, and may have prevented some renal scarring.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.