Is shorter antibiotic treatment duration increasing the risk of relapse in paediatric acute focal bacterial nephritis?

Scenario A 12-year-old girl presented with another episode of pyelonephritis. Her history was remarkable for multiple prior episodes of pyelonephritis over several months. Each episode was accompanied by flank pain and fever. Urine culture showed Escherichia coli on all occasions. Treatment for the first episodes was with oral cephalosporins for 10 days. Renal ultrasound did not show any abnormality of the urinary tract and the performed uroflow was normal. Underlying risk factors for recurrence of pyelonephritis such as bowel–bladder dysfunction and constipation were ruled out. A sufficient oral fluid intake as well as complete bladder voiding were discussed with the patient and her parents and were reported to be adequate. During the current episode, an MRI was performed, suggesting a diagnosis of an acute focal bacterial nephritis (AFBN). A 2-week course of intravenous ceftriaxone was given followed by oral prophylactic treatment. Nonetheless, clinical relapse and new renal lesions...
Source: Archives of Disease in Childhood - Category: Pediatrics Authors: Tags: ADC Archimedes Source Type: research