The February 2008 issue of Pediatrics magazine published the results of a prospective multicenter randomized study by French researchers comparing the effects of a short (3 days) and long (8 days) course of intravenous (iv) ceftriaxone for the treatment of pyelonephritis in children for the appearance of scar changes in the renal parenchyma 6-9 months after the onset of the disease.

During labor after initial treatment with netilmecin and ceftriaxone iv, patients were randomized either to oral antibiotic therapy for 5 days (short iv course) or to continue intravenous administration of ceftriaxone for 5 days (long iv course) )) The criteria for inclusion in the study were: the child's age from 3 months to 16 years of age, the first episode of acute pyelonephritis, determined by the presence of fever greater than 38.5 ° C, the level reactive protein C is greater than 20 mg / l, and clinically significant bacteriuria (more than 105 CFU) / ml). All patients in the follow-up period (6 to 9 months after the pyelonephritis episode) underwent renal scintigraphy with technetium-99 dimercaptosuccinic acid.

The study included 548 children, 48 patients were excluded from the study during treatment and 117 patients were "lost" during the follow-up period or had an incomplete set of information necessary for analysis, for Therefore, 383 children were evaluated at the end of the study, 205 of them patients belonged to the short-term ceftriaxone IV group, and in 178, ceftriaxone IV was used for 8 days (therapy group long-term).

At baseline, the mean age of the patients was 15 months, the mean duration of fever before being included in the study was 43 hours, and the mean level of CRP was 122 mg / L. In 37% of patients (143 children), vesicoureteral reflux of 1 to 3 degrees was noted. The characteristics of the patients at the time of inclusion were comparable between the study groups, except for a slightly higher proportion of girls in the short-term antibiotic IV group.

As this study showed, the incidence of scarring changes in the kidneys detected by scintigraphy was comparable between the groups compared. During a multiple analysis, it was found that the risk factor for the formation of scar changes in the kidneys is the presence of grade 3 vesicoureteral reflux. Thus, the authors conclude that the incidence of scar changes in the kidney does not depend on the duration of parenteral antibiotic therapy.