{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:41:04Z","timestamp":1747183264858,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the efficacy and safety of home\u2010treatment with oral piv\u2010mecillinam or amoxicillin\u2010clavulanate in children with acute pyelonephritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children aged over 6\u00a0months diagnosed with culture confirmed pyelonephritis at Danish Paediatric Departments were home\u2010treated with piv\u2010mecillinam (tablets) or amoxicillin\u2010clavulanate (liquid or tablets). Follow\u2010up was performed by phone (second treatment day) and clinical review of the patients in the hospital (day three).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred eighteen children were included. In total, 333\/418 (80%) responded well to the initial oral antibiotic treatment. 85\/418 (20%) were changed to another treatment of these 47\/418 (11%) to a second\u2010line oral antibiotic and 38\/418 (9%) to intravenous antibiotics due to insufficient clinical improvement or bacterial resistance. Bacterial resistance was similar for piv\u2010mecillinam and amoxicillin\u2010clavulanate: 4\/74 (5%) versus 33\/333 (10%) (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.22). Insufficient clinical improvement, despite no resistance, primarily occurred in children treated with piv\u2010mecillinam: 16\/74 (22%) versus 28\/344 (8%) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and predominantly occurred in piv\u2010mecillinam treated children &lt;5\u00a0years: 7\/20 (35%) versus 9\/54 (17%) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05), potentially because of problems with piv\u2010mecillinam tablets. In the study population no cases of death or septicemia developed after start of initial oral treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A home\u2010treatment regime for pyelonephritis in children &gt;6\u00a0months is safe; however, during treatment, clinical re\u2010evaluation is required as in 20% of cases a change in treatment was necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.15958","type":"journal-article","created":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T17:58:58Z","timestamp":1622311138000},"page":"2627-2634","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Children with acute pyelonephritis need medical re\u2010evaluation when home\u2010treated with oral antibiotics"],"prefix":"10.1111","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0296-2524","authenticated-orcid":false,"given":"Line Thousig","family":"Sehested","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Copenhagen University Hospital Hvidovre Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Kamperis","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Aarhus University Hospital Aarhus Denmark"},{"name":"Faculty of Medical and Health Sciences University of Aarhus Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Winding","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Lillebaelt Hospital Kolding Kolding Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte Kj\u00e6r","family":"Bjerre","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Copenhagen University Hospital Hilleroed Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mette","family":"Neland","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Odense University Hospital Odense Denmark"},{"name":"Faculty of Medical and Health Sciences University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f8ren","family":"Hagstr\u00f8m","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Aalborg Hospital Aalborg Denmark"},{"name":"Faculty of Medical and Health Sciences University of Aalborg Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Line K\u00f8nig","family":"Wilms","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Naestved Hospital Naestved Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Louise Elkj\u00e6r","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Hospitalsenhed Midt Viborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Kuhne\u2010Qvist","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Hospital of South West Jutland Esbjerg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jette Skj\u00f8de","family":"Hoffmann\u2010Petersen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Herning Hospital Herning Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanne","family":"N\u00f8rgaard","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina","family":"Cortes","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence Medicine Copenhagen University Hospital Hvidovre Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,11]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_10_2_1","DOI":"10.1136\/adc.66.2.232"},{"key":"e_1_2_10_3_1","first-page":"5775","article-title":"Referenceprogram for b\u00f8rn med urinvejsinfektion. 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