Practices vary significantly as clinicians evaluate and manage febrile infants younger than 2 months of age. A retrospective review suggests that meningitis is extremely unlikely in well-appearing babies with initial laboratory results suggestive of urinary tract infection, and that cerebrospinal fluid analysis may not be necessary.
The duration of parenteral antimicrobial therapy for bacteremic urinary tract infection in young infants varies between practitioners and centers. A retrospective review suggests that extending parenteral treatment beyond seven days does not alter outcomes.
New guideline recommendations indicate that the only unequivocal indications for screening and treatment of asymptomatic bacteriuria are pregnancy and undergoing endoscopic urologic procedures associated with mucosal injury.
A multicenter, retrospective, cohort study from southern and eastern Europe identified predictive factors for multidrug-resistant complicated urinary tract infections (cUTI), which included male sex, cUTI acquisition in a healthcare facility, presence of a Foley catheter, having a UTI in the previous year, and receiving an antibiotic in the preceding 30 days.
A randomized, open-label, superiority trial found that daily antibiotic prophylaxis for patients who use clean, intermittent self-catheterization reduced symptomatic urinary tract infections by 48% over a 12-month period. Antibiotic resistance became prevalent in urinary isolates from the group receiving prophylaxis compared to controls.