Study supports shorter antibiotic courses for kids with uncomplicated urinary tract infections

News brief

Textbook page with urinary tract infection definition — designer491 / iStock

A new study by researchers in Singapore and China indicates that shorter antibiotic courses are reasonable for children with uncomplicated urinary tract infections (UTIs).

In a review and meta-analysis published yesterday in Clinical Microbiology and Infection, the researchers analyzed data from 13 randomized clinical trials (RCTs) that compared shorter-course (two to five days) versus longer-course (seven or more days) antibiotic therapy in children with uncomplicated UTIs.

While most guidelines recommend anywhere from seven to 14 days of antibiotics, concerns about antibiotic overuse in children and observations by clinicians that many children with UTIs achieve clinical stability within three days of treatment have raised questions about those recommendations.

“A key area of debate concerns the optimal duration of antibiotic therapy, particularly whether treatment should be discontinued upon symptom resolution or continued to complete the full guideline-recommended course,” the study authors write.

Analysis of the 13 RCTs, which involved more than 2,000 children (mean age, 5.9 years), found moderate- to high-certainty evidence that shorter-course antibiotic therapy “probably” results in in no difference in relapse rate (risk ratio [RR], 1.08) or reinfection rate (RR, 0.63) compared with longer-course therapy.

Low-certainty evidence showed that shorter-course therapy “may result in little or no difference” in bacteriologic cure rate (RR, 0.96) or clinical cure rate (RR, 0.99), while moderate-certainty evidence demonstrated no difference in adverse-event rates (RR, 0.93).

Limited data on infants, kids with recurrent UTIs

“A shorter-course regimen, with appropriate follow-up, may be considered a reasonable option following a thorough discussion of the potential risks and benefits in clinical practice for children with acute uncomplicated UTI,” the authors conclude.

The researchers say the findings are in line with other recently published meta-analyses. But they note that because of limited data, it’s uncertain if the findings can be applied to infants aged 2 months to 2 years, children with a history of recurrent UTIs, and those who have UTIs with fever. Further research to determine the optimal antibiotic duration for these subgroups will be needed, they add.

Quick takes: Salmonella outbreak tied to chameleons, restricted healthcare student loans, HIV in Manitoba, new polio cases

News brief

Mary Van Beusekom, MS

Five children aged 2 years or younger in four US states (Iowa, Nebraska, Oklahoma, and Texas) have been sickened, and two hospitalized, in an outbreak of Salmonella Woodinville linked to pet veiled chameleons, the Centers for Disease Control and Prevention (CDC) said in a news release yesterday. Illness onset dates were from February 12 to April 10, 2026. The children were from families who had bought veiled chameleons at different stores. The agency said it recommends against children younger than 5 having reptiles as pets because that age-group is especially likely to become seriously ill from pathogens reptiles can carry. “Veiled chameleons and other reptiles can carry Salmonella germs in their droppings even if they look healthy and clean,” the news release said. “These germs can easily spread to their bodies and anything in the area where they live and roam.”
This week, after redefining the term “professional,” the Trump administration restricted loans for students planning careers as advanced-practice nurses, physician assistants, occupational therapists, physical therapists, speech-language therapists, social workers, counseling and mental health practitioners, social workers, health administrators, and public health or teaching posts. Instead, loans will be limited to those seeking terminal degrees in medicine, pharmacy, dentistry, veterinary medicine, chiropractic medicine, law, optometry, osteopathic medicine, podiatry, or theology. People pursuing these careers will be eligible for up to $50,000 in federal loans per year or $200,000 in total, while the others will be limited to $20,500 annually or $100,000 in total.
Manitoba has declared a public health emergency over rising rates of HIV infection, with an incidence more than triple that of Canada’s nationwide rate, CBC reports. In 2024, the province reported 19.5 cases per 100,000 people, more than three-fold higher than the national rate of 5.5. Provincial health officials say the drivers of the surge may include intravenous drug use, homelessness, mental illness, an increase in other sexually transmitted and bloodborne infections, and barriers to care.
The Global Polio Eradication Initiative this week reported 10 new polio cases in Chad, the Democratic Republic of the Congo (DRC), Nigeria, and Pakistan. Chad documented two circulating vaccine-derived poliovirus type 2 (cVDPV2) cases in the Logone Oriental region, with paralysis onsets of March 12, 2026. Last year, the country posted 31 cVDPV2 cases; so far this year, four cases have been reported. In the DRC, one cVDPV2 case was recorded in Maniema province, with an onset of paralysis of February 17, 2026. There were six cVDPV2 cases in 2025 and six so far in 2026. Nigeria posted three cVDPV2 cases in Zamfara and Bauchi states, with paralysis beginning in February and March 2026. Sixty-six cases were documented last year, and 17 have been noted this year. The country also reported two circulating vaccine-derived poliovirus type 3 (cVDPV3) cases this week in Yobe and Borno states, with paralysis starting on February 4, 2025, and March 29, 2026, respectively. The 2025 cVPDV3 tally was seven, with three so far this year.