Lancet Infect Dis
Individualized antibiotic treatment reduced antibiotic exposure in children with febrile UTI
Individualized antibiotic treatment for febrile urinary tract infection (UTI) in children reduced overall antibiotic exposure and associated adverse events, supporting antimicrobial stewardship goals. However, it was associated with a slightly higher risk of recurrent UTI.
Study details: INDI-UTI, a multicenter pragmatic trial, evaluated whether individualized antibiotic treatment was non-inferior to standard 10-day treatment in terms of recurrent UTIs and superior in reducing overall exposure to antibiotics. Participants (N = 408; median age, 1.5 years; 80% female) with febrile UTI were randomized to receive either individualized antibiotic treatment, stopping 3 days after clinical improvement (n = 205), or standard 10-day treatment (n = 203).
Results: Median antibiotic duration was 5.3 days in the individualized group vs. 10 days in the standard group. Recurrent UTI within 28 days occurred in 11% of the individualized group vs. 6% in the standard group (difference 5.3 percentage points; P non_inferiority = 0.24). Total antibiotic days were significantly lower in the individualized group (median difference -4.0 days, p<0.0001). The incidence rate of antibiotic-related adverse events was lower in the individualized group (rate ratio 0.61, P = 0.0003).
Source:
Sethi NJ, et al. (2025, April 2). Lancet Infect Dis. Efficacy and safety of individualised versus standard 10-day antibiotic treatment in children with febrile urinary tract infection (INDI-UTI): a pragmatic, open-label, multicentre, randomised, controlled, non-inferiority trial in Denmark. https://pubmed.ncbi.nlm.nih.gov/40187361/