Study suggests shorter IV antibiotic durations for young infants with UTIs
A review and meta-analysis of studies on urinary tract infections (UTIs) in young infants suggests shorter intravenous (IV) antibiotic courses, with an early switch to oral antibiotics, should be considered, Australian researchers reported yesterday in Pediatrics.
While international guidelines recommend admitting all infants 90 days or younger with a UTI to the hospital for initial IV antibiotic therapy, there is no consensus on the optimal time for when young infants can be safely switched from IV to oral therapy, and considerable variation in IV antibiotic duration for UTIs in this age-group remains. To determine if a shorter IV course may be appropriate for young infants with UTIs, researchers screened 10,181 records and identified 18 studies involving 16,615 young infants that met the inclusion criteria.
The largest two studies on bacteremic UTI found no difference in the rates of 30-day recurrence or 30-day all-cause hospitalization between young infants who received 7 days or less of IV antibiotics and those who received more than 7 days.
For infants with non-bacteremic UTIs, there was no significant difference in the 30-day adjusted recurrence rate between those treated with 3 days or less of IV antibiotics and those treated with more than 3 days. Three studies used oral antibiotics alone and reported good outcomes, although only 85 infants in those studies were 90 days or younger.
"These findings have important implications for clinical practice, because shorter IV antibiotic courses with an early switch to oral therapy can improve the quality of life of children and their families, reduce the length of hospital stay, the risk of nosocomial infections, and health care costs," the review authors wrote.
The authors note that the recommendations are only for young infants when meningitis has been excluded and who have no features of sepsis.
Jan 24 Pediatrics abstract
H9N2 avian flu sickens 1 more in China
China reported one more human H9N2 avian flu case, which involves a 5-year-old boy from Anhui province, Hong Kong's Centre for Health Protection (CHP) said in its latest avian influenza update.
The boy's symptoms began on Nov 13, 2021. The report didn't note the exposure source or clinical details.
China reported a spurt of 11 H9N2 infections in the final months of 2021. Illnesses involving the subtype are rare, most commonly affecting children. Infections are typically mild, but in November, China reported a fatal infection in an adult.
The virus is common in Asian poultry, and many cases involve close contact with poultry or poultry environments.
Jan 25 Hong Kong CHP avian flu report
H5N3 avian flu detected in German waterfowl
Animal health officials in Germany recently reported a highly pathogenic H5N3 avian flu event involving a wild bird found in Mecklenburg-Vorpommern state, according to a notification to the World Organisation for Animal Health (OIE).
The outbreak began on Dec 22. The water bird that tested positive was destroyed to curb the spread of the virus. The event marks Germany's first H5N3 detection since May 2021. Mecklenburg-Vorpommern state is in the country's northeast.
In November, the OIE urged increased avian flu surveillance owing to expanding poultry outbreaks and detections in wild birds. It said an unprecedented number of subtypes are circulating, including H5N1, H5N3, H5N4, H5N5, H5N6, and H5N8. Human illnesses involving the strains are very rare but can sometimes occur in people who have contact with poultry.
Jan 24 OIE report on H5N3 in Germany