A Comparison of Short Versus Long Course Intravenous Antibiotics When Treating Urinary Tract Infection in Infants <60 Days of Age

Urinary tract infections (UTIs) are a common reason for hospitalization in infants younger than 60 days, and the optimal approach to intravenous (IV) antibiotic therapy upon UTI diagnosis in this cohort is unknown. We determined whether there was an association between IV antibiotic therapy duration (long [>3 days] vs short [≤3 days]) and treatment failure via a retrospective review of infants with confirmed UTIs receiving IV antibiotics at a tertiary referral center. A total of 403 infants were included; 39% were treated with ampicillin and cefotaxime, and 34% with ampicillin and gentamycin or tobramycin. The median IV antibiotic duration was 5 (interquartile range: 3-10) days, and 5% of patients experienced treatment failure. The treatment failure rate was similar in both short- and long-course IV antibiotic groups (P > .05), and there was no significant association between treatment duration and failure. We conclude that treatment failure for infants hospitalized with UTI is uncommon and not associated with IV antibiotic duration.