Status:

COMPLETED

Individualized Antibiotic Therapy in Children With Acute Uncomplicated Febrile Urinary Tract Infection

Lead Sponsor:

Rigshospitalet, Denmark

Collaborating Sponsors:

Hvidovre University Hospital

Conditions:

Febrile Urinary Tract Infection

Eligibility:

All Genders

3-12 years

Phase:

PHASE4

Brief Summary

An investigator-initiated, open-label, multi-center, randomized, non-inferiority trial of children aged 3 months to 13 years with acute uncomplicated febrile urinary tract infection. The primary objec...

Eligibility Criteria

Inclusion

  • Clinical suspicion of febrile (≥38 °C) urinary tract infection.
  • Positive urine culture of uropathogenic bacteria obtained by either suprapubic bladder aspiration, sterile intermittent catheterization, or midstream urine.
  • Suprapubic bladder aspiration: any growth of bacteria.
  • Sterile intermittent catheterization: monoculture with ≥10\^3 cfu/ml.
  • Midstream urine x 2: Monoculture with the bacteria in both tests with ≥10\^4 cfu/ml.
  • Midstream urine x 2: Monoculture with the bacteria in both tests with ≥10\^5 cfu/ml in one test and 10\^3 cfu/ml in another test.
  • Midstream urine x 1 (≥10 years of age): Monoculture with ≥10\^5 cfu/ml.
  • 3 months to 13 years of age (corrected age in case of premature birth).
  • Parents fluent in Danish or English.
  • Informed consent both parents.
  • All children who do not receive any empirical antibiotic therapy but have a positive urine culture (approximately 48 hours after urine sample collection) can be included if fever (≥ 38.0 °C) is present and the child is initiated with relevant antibiotic therapy. ¨
  • Children can be included regardless of whether intravenous or oral antibiotics were given as empirical therapy.

Exclusion

  • Non-Danish civil registration number.
  • Not resident in the Capital Region or Region Zealand in Denmark at primary visit.
  • Previous inclusion in the trial.
  • History of febrile (≥38 °C) urinary tract infection in the last 28 days before the primary visit.
  • Antibiotic treatment in the last two weeks before the primary visit.
  • Three or more episodes with febrile (≥38 °C) urinary tract infection within one year of the primary visit (including the current episode).
  • Previous complicated episode of febrile (≥38 °C) urinary tract infection (e.g., renal abscess or urosepticemia)
  • Non-compliance ≥3 doses of antibiotics during empirical therapy.
  • Elevated creatinine.
  • Prophylactic antibiotic treatment.
  • Known urogenital abnormalities (i.e., obstructing uropathies; vesicoureteral reflux; multicystic dysplasia; renal dysplasia; renal hypoplasia; renal agenesis; duplex kidney; polycystic kidney disease; neurogenic bladder dysfunction; hypospadias).
  • Septic.
  • Positive blood culture (if contamination is not suspected).
  • Immune deficiency.
  • Systemic immunosuppressive therapy.

Key Trial Info

Start Date :

April 1 2022

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

June 8 2024

Estimated Enrollment :

408 Patients enrolled

Trial Details

Trial ID

NCT05301023

Start Date

April 1 2022

End Date

June 8 2024

Last Update

July 8 2024

Active Locations (8)

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Page 1 of 2 (8 locations)

1

Copenhagen University Hospital Rigshospitalet

Copenhagen, Denmark, 2100

2

Copenhagen University Hospital Herlev

Herlev, Denmark, 2730

3

Copenhagen University Hospital Hillerød

Hillerød, Denmark, 3400

4

Copenhagen University Hospital Holbæk

Holbæk, Denmark, 4300