Hum et al evaluated febrile pediatric patients with a urinary tract infection (UTI) and identified risk factors associated with delayed antibiotic therapy. Delayed antibiotic therapy can result in a number of complications. The authors are from the University of Pittsburgh and Children's Hospital of Pittsburgh.

Patient selection: febrile pediatric patient with urinary tract infection (mean age 17 months)


Delay in therapy is defined as the number of hours between fever onset and the start of antimicrobial therapy.


Risk factors for delayed antibiotic therapy:

(1) age >= 12 months of age

(2) presence of commercial insurance


If urine testing is sent to a laboratory then results may take longer than if a result is readily available.


Complications of delayed antibiotic therapy:

(1) pyelonephritis with renal scarring

(2) sepsis


Parents should seek prompt therapy of a urinary tract infection, especially if the child has a history of UTIs.

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