Trial reportBMJ (Clinical research ed.)2007
Antibiotic treatment for pyelonephritis in children: multicentre randomised controlled non-inferiority trial.
Trial report in BMJ (Clinical research ed.), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 56 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
A Multicenter Randomized Controlled Trial of Antibiotic Treatment in Children With Urinary Tract Infections: Oral Amoxicillin/Clavulanic Acid vs Initial iv Ceftriaxone.
7-day Compared With 10-day Antibiotic Treatment for Febrile Urinary Tract Infections in Children: a Randomized Controlled Trial
Who cites it
56 citing papers in PubMed, 10 syntheses or guidelines pooled it, 203 citations in OpenAlex.
- Do Various Treatment Modalities of Vesicoureteral Reflux Have Any Adverse Effects in Pediatric Patients? A Meta-Analysis.Urologia internationalis · 2021Pooled it
- Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children.The Cochrane database of systematic reviews · 2020Pooled it
- Long-term antibiotics for preventing recurrent urinary tract infection in children.The Cochrane database of systematic reviews · 2019Pooled it
- Interventions for primary vesicoureteric reflux.The Cochrane database of systematic reviews · 2019Pooled it
- Pooled it
- Efficacy of antibiotic prophylaxis in children with vesicoureteral reflux: systematic review and meta-analysis.The Journal of urology · 2015Pooled it
- Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children.The Cochrane database of systematic reviews · 2015Pooled it
- Antibiotics for acute pyelonephritis in children.The Cochrane database of systematic reviews · 2014Pooled it
- Antibiotics for treating lower urinary tract infection in children.The Cochrane database of systematic reviews · 2012Pooled it
- Urinary tract infection in children.BMJ clinical evidence · 2010Pooled it
- Oral steroids for reducing kidney scarring in young children with febrile urinary tract infections: the contribution of Bayesian analysis to a randomized trial not reaching its intended sample size.Pediatric nephrology (Berlin, Germany) · 2021Trial
- Trial
- Etiological and Resistance Profile of Bacteria Involved in Urinary Tract Infections in Young Children.BioMed research international · 2017Trial
- Trial
- Length of intravenous antibiotic therapy and treatment failure in infants with urinary tract infections.Pediatrics · 2010Trial
- Ceftibuten versus trimethoprim-sulfamethoxazole for oral treatment of febrile urinary tract infection in children.Pediatric nephrology (Berlin, Germany) · 2009Trial
- Randomised trial of oral versus sequential intravenous/oral cephalosporins in children with pyelonephritis.European journal of pediatrics · 2008Trial
- Antibiotic Stewardship in Pediatric Urinary Tract Infections: Current Evidence and Practical Strategies.Antibiotics (Basel, Switzerland) · 2026Review
- Predictive value of normal renal ultrasound after first febrile UTI in infants under six months: a retrospective chart review.World journal of urology · 2026Article
- Response letter to UTI in infants: less is more, together is better.Pediatric nephrology (Berlin, Germany) · 2025Article
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Authors and funding
18 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the efficacy of oral antibiotic treatment alone with treatment started parenterally and completed orally in children with a first episode of acute pyelonephritis.
designMulticentre, randomised controlled, open labelled, parallel group, non-inferiority trial.
setting28 paediatric units in north east Italy.
participants502 children aged 1 month to <7 years with clinical pyelonephritis.
interventionOral co-amoxiclav (50 mg/kg/day in three doses for 10 days) or parenteral ceftriaxone (50 mg/kg/day in a single parenteral dose) for three days, followed by oral co-amoxiclav (50 mg/kg/day in three divided doses for seven days). Main outcomes measures Primary outcome was the rate of renal scarring. Secondary measures of efficacy were time to defervescence (<37 degrees C), reduction in inflammatory indices, and percentage with sterile urine after 72 hours. An exploratory subgroup analysis was conducted in the children in whom pyelonephritis was confirmed by dimercaptosuccinic acid (DMSA) scintigraphy within 10 days after study entry.
resultsIntention to treat analysis showed no significant differences between oral (n=244) and parenteral (n=258) treatment, both in the primary outcome (scarring scintigraphy at 12 months 27/197 (13.7%) v 36/203 (17.7%), difference in risk -4%, 95% confidence interval -11.1% to 3.1%) and secondary outcomes (time to defervescence 36.9 hours (SD 19.7) v 34.3 hours (SD 20), mean difference 2.6 (-0.9 to 6.0); white cell count 9.8x10(9)/l (SD 3.5) v 9.5x10(9)/l (SD 3.1), mean difference 0.3 (-0.3 to 0.9); percentage with sterile urine 185/186 v 203/204, risk difference -0.05% (-1.5% to 1.4%)). Similar results were found in the subgroup of 278 children with confirmed acute pyelonephritis on scintigraphy at study entry.
conclusionsTreatment with oral antibiotics is as effective as parenteral then oral treatment in the management of the first episode of clinical pyelonephritis in children.
trial registrationClinical Trials NCT00161330 [ClinicalTrials.gov].
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What OpenQuestion holds
Registered trials
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.