Adamos Hadjipanayis1, Zachi Grossman2, Stefano Del Torso3, Diego van Esso4, Hans Juergen Dornbusch5, Artur Mazur6, Anna Drabik7, Giovanni Montini8. 1. Faculty of Medicine, European University Cyprus, Larnaca General Hospital, Derynia, Cyprus. 2. Pediatric Clinic, Maccabi Health Services, Tel Aviv, Israel. 3. Pediatra di Famiglia ULSS 16, Studio Pediatrico Vecellio 33, Padova, Italy. 4. Primary Care Health Centre 'Pare Claret', Catalan Institute of Health, Barcelona, Spain. 5. Grazerstrasse 34b, Graz, Austria. 6. Medical Faculty, University of Rzeszów, Rzeszów, Poland. 7. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 8. Nephrology and Dialysis Unit, Department of Paediatrics, Azienda Ospedaliero Universitaria Sant'Orsola-Malpighi, Bologna, Italy.
Abstract
OBJECTIVE: To describe current practice among European paediatricians regarding diagnosis and management of urinary tract infections in children aged 1-36 months and to compare these practices with recently published guidelines. DESIGN: Web-based large scale survey evaluating knowledge of, attitudes towards and the methods for diagnosing, treating and managing urinary tract infections in children. SETTING: Primary and secondary care practices in Europe. SAMPLE: 1129 paediatricians. RESULTS: A diagnosis of urinary tract infection is considered by 62% of the respondents in children aged 1-36 months with unexplained fever. The preferred method of urine collection is use of a bag (53% for infants <3 months and 59% for children 4-36 months of age). 60% of paediatricians agree that oral and parenteral antibiotics have equal efficacy. Co-amoxiclav is the antibiotic of choice for 41% of participants, while 9% prescribe amoxicillin. 80% of respondents prescribe ultrasound in all children with a confirmed urinary tract infection. 63% of respondents prescribe a cystography when abnormalities are revealed during ultrasound evaluation. A quarter of respondents recommend antibiotic prophylaxis for all children with any vesicoureteral reflux. The data among European countries are very heterogeneous. The three most recent urinary tract infection guidelines (the National Institute for Health and Care Excellence (NICE), the American Academy of Paediatrics and the Italian Society of Paediatric Nephrology) are not followed properly. CONCLUSIONS: Management of febrile urinary tract infections remains controversial and heterogeneous in Europe. Simple, short, practical and easy-to-remember guidelines and educational strategies to ensure their implementation should be developed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: To describe current practice among European paediatricians regarding diagnosis and management of urinary tract infections in children aged 1-36 months and to compare these practices with recently published guidelines. DESIGN: Web-based large scale survey evaluating knowledge of, attitudes towards and the methods for diagnosing, treating and managing urinary tract infections in children. SETTING: Primary and secondary care practices in Europe. SAMPLE: 1129 paediatricians. RESULTS: A diagnosis of urinary tract infection is considered by 62% of the respondents in children aged 1-36 months with unexplained fever. The preferred method of urine collection is use of a bag (53% for infants <3 months and 59% for children 4-36 months of age). 60% of paediatricians agree that oral and parenteral antibiotics have equal efficacy. Co-amoxiclav is the antibiotic of choice for 41% of participants, while 9% prescribe amoxicillin. 80% of respondents prescribe ultrasound in all children with a confirmed urinary tract infection. 63% of respondents prescribe a cystography when abnormalities are revealed during ultrasound evaluation. A quarter of respondents recommend antibiotic prophylaxis for all children with any vesicoureteral reflux. The data among European countries are very heterogeneous. The three most recent urinary tract infection guidelines (the National Institute for Health and Care Excellence (NICE), the American Academy of Paediatrics and the Italian Society of Paediatric Nephrology) are not followed properly. CONCLUSIONS: Management of febrile urinary tract infections remains controversial and heterogeneous in Europe. Simple, short, practical and easy-to-remember guidelines and educational strategies to ensure their implementation should be developed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Jonathan Kaufman; Patrick Fitzpatrick; Shidan Tosif; Sandy M Hopper; Susan M Donath; Penelope A Bryant; Franz E Babl Journal: BMJ Date: 2017-04-07
Authors: Jonathan Kaufman; Patrick Fitzpatrick; Shidan Tosif; Sandy M Hopper; Penelope A Bryant; Susan M Donath; Franz E Babl Journal: BMJ Open Date: 2016-08-10 Impact factor: 2.692