{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:14:25Z","timestamp":1791501265917,"version":"4.3.4"},"reference-count":17,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>To confirm whether oral antibiotic treatment is as efficacious as sequential intravenous\/oral antibiotic treatment in the prevention of renal scarring in children with acute pyelonephritis and scintigraphy-documented acute lesions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>In a prospective multicenter trial, children aged 1 to 36 months with their first case of acute pyelonephritis, a serum procalcitonin concentration \u22650.5 ng\/mL, no known uropathy, and a normal ultrasound exam were randomized into 2 treatment groups. They received either oral cefixime for 10 days or intravenous ceftriaxone for 4 days followed by oral cefixime for 6 days. Patients with acute renal lesions detected on early dimercaptosuccinic acid scintigraphy underwent a follow-up scintigraphy 6 to 8 months later.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>The study included 171 infants and children. There were no significant differences between the 2 groups in any clinical characteristic. Initial scintigraphy results were abnormal for 119 children. Ninety-six children were measured for renal scarring at the follow-up scintigraphy (per protocol analysis population). The incidence of renal scarring was 30.8% in the oral treatment group and 27.3% for children who received the sequential treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Although this trial does not statistically demonstrate the noninferiority of oral treatment compared with the sequential treatment, our study confirmed the results of previously published reports and therefore supports the use of an oral antibiotic treatment of primary episodes of acute pyelonephritis in infants and young children.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2011-0814","type":"journal-article","created":{"date-parts":[[2012,1,31]],"date-time":"2012-01-31T05:38:25Z","timestamp":1327988305000},"page":"e269-e275","source":"Crossref","is-referenced-by-count":79,"title":["Randomized Trial of Oral Versus Sequential IV\/Oral Antibiotic for Acute Pyelonephritis in Children"],"prefix":"10.1542","volume":"129","author":[{"given":"Nathalie","family":"Bocquet","sequence":"first","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Necker Enfants Malades, Service des Urgences P\u00e9diatriques, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Sergent Alaoui","sequence":"additional","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Armand Trousseau, Service de M\u00e9decine Nucl\u00e9aire, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pierre","family":"Jais","sequence":"additional","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris Service de Biostatistique, H\u00f4pital Necker Enfants Malades, Paris, France;"},{"name":"Universit\u00e9 Paris Descartes, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Gajdos","sequence":"additional","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris, Service de P\u00e9diatrie, H\u00f4pital Antoine B\u00e9cl\u00e8re, Clamart, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Guigonis","sequence":"additional","affiliation":[{"name":"Service de P\u00e9diatrie, H\u00f4pital Universitaire Dupuytren, Limoges, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Lacour","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes, Paris, France;"},{"name":"Assistance Publique-H\u00f4pitaux de Paris, Service de Biochimie A, H\u00f4pital Necker Enfants Malades, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Ch\u00e9ron","sequence":"additional","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Necker Enfants Malades, Service des Urgences P\u00e9diatriques, Paris, France;"},{"name":"Universit\u00e9 Paris Descartes, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,2,1]]},"reference":[{"issue":"6","key":"2021120903115959500_B1","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1542\/peds.2010-3465","article-title":"National ambulatory antibiotic prescribing patterns for pediatric urinary tract infection, 1998-2007","volume":"127","author":"Copp","year":"2011","journal-title":"Pediatrics"},{"issue":"1 pt 1","key":"2021120903115959500_B2","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1542\/peds.104.1.79","article-title":"Oral versus initial intravenous therapy for urinary tract infections in young febrile children","volume":"104","author":"Hoberman","year":"1999","journal-title":"Pediatrics"},{"key":"2021120903115959500_B3"},{"issue":"9","key":"2021120903115959500_B4","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00431-007-0638-1","article-title":"Randomised trial of oral versus sequential intravenous\/oral cephalosporins in children with pyelonephritis","volume":"167","author":"Neuhaus","year":"2008","journal-title":"Eur J Pediatr"},{"issue":"3","key":"2021120903115959500_B5","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1136\/adc.84.3.241","article-title":"Randomised controlled trial of three day versus 10 day intravenous antibiotics in acute pyelonephritis: effect on renal scarring","volume":"84","author":"Benador","year":"2001","journal-title":"Arch Dis Child"},{"issue":"6","key":"2021120903115959500_B6","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1007\/s00467-009-1125-x","article-title":"Procalcitonin as a predictor of renal scarring in infants and young children","volume":"24","author":"Bressan","year":"2009","journal-title":"Pediatr Nephrol"},{"issue":"1","key":"2021120903115959500_B7","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s004670050243","article-title":"The evaluation of acute pyelonephritis and renal scarring with technetium 99m-dimercaptosuccinic acid renal scintigraphy: evolving concepts and future directions","volume":"11","author":"Rushton","year":"1997","journal-title":"Pediatr Nephrol"},{"issue":"4","key":"2021120903115959500_B8","first-page":"CD003772","article-title":"Antibiotics for acute pyelonephritis in children","author":"Hodson","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"2021120903115959500_B9","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s00467-001-0790-1","article-title":"Procalcitonin as a marker of acute pyelonephritis in infants and children","volume":"17","author":"Smolkin","year":"2002","journal-title":"Pediatr Nephrol"},{"issue":"2","key":"2021120903115959500_B10","doi-asserted-by":"crossref","DOI":"10.1542\/peds.114.2.e249","article-title":"Procalcitonin: a marker of severity of acute pyelonephritis among children","volume":"114","author":"Pecile","year":"2004","journal-title":"Pediatrics"},{"issue":"6","key":"2021120903115959500_B11","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1542\/peds.102.6.1422","article-title":"Procalcitonin is a marker of severity of renal lesions in pyelonephritis","volume":"102","author":"Benador","year":"1998","journal-title":"Pediatrics"},{"issue":"7616","key":"2021120903115959500_B12","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1136\/bmj.39286.700891.AD","article-title":"Diagnosis and management of urinary tract infection in children: summary of NICE guidance","volume":"335","author":"Mori","year":"2007","journal-title":"BMJ"},{"key":"2021120903115959500_B13"},{"key":"2021120903115959500_B14","unstructured":"AFSSAPS Diagnostic et antibioth\u00e9rapie des infections urinaires bact\u00e9riennes communautaires du nourisson et de l\u2032enfant - Recommandations de bonne pratique. Available at: www.afssaps.fr\/Infos-desecurite. 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