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Adherence to the Swedish paediatric guidelines for urinary tract infections

Lindén, Magnus ; Rosenblad, Therese LU ; Hansson, Sverker and Brandström, Per (2024) In Acta Paediatrica, International Journal of Paediatrics
Abstract

Aim: To audit adherence to the Swedish paediatric guidelines for urinary tract infections (UTIs) in infants. Secondary objectives were to compare findings on imaging performed according to the guidelines with imaging without guideline support and to identify predictors of non-adherence. Methods: A prospective multicentre study of infants <1 year treated at paediatric hospitals for their first UTI. Adherence to recommendations was assessed for diagnosis, treatment, and imaging of the urinary tract with a follow-up period of 1 year. Vesicoureteral reflux on voiding cystourethrography and findings on renal scintigraphy according to recommendations were compared to imaging without recommendation. Results: A total of 1357 infants were... (More)

Aim: To audit adherence to the Swedish paediatric guidelines for urinary tract infections (UTIs) in infants. Secondary objectives were to compare findings on imaging performed according to the guidelines with imaging without guideline support and to identify predictors of non-adherence. Methods: A prospective multicentre study of infants <1 year treated at paediatric hospitals for their first UTI. Adherence to recommendations was assessed for diagnosis, treatment, and imaging of the urinary tract with a follow-up period of 1 year. Vesicoureteral reflux on voiding cystourethrography and findings on renal scintigraphy according to recommendations were compared to imaging without recommendation. Results: A total of 1357 infants were included. Adherence to recommended diagnostic procedures, antibiotic treatment, and imaging was 86.1%, 91.0% and 64.2%, respectively. Non-adherence to imaging recommendations was associated with inpatient management and smaller hospitals but was also more often due to excessive rather than refrained imaging. Conclusion: High adherence rates to diagnostic and treatment recommendations indicate careful attention to infant UTI among paediatricians. Lower adherence to imaging recommendations raises concerns regarding the guideline algorithm; particularly, early DMSA scans seem to be challenging for smaller hospitals.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
adherence, clinical guidelines, infant, urinary tract infection
in
Acta Paediatrica, International Journal of Paediatrics
publisher
Wiley-Blackwell
external identifiers
  • pmid:39692082
  • scopus:85212509420
ISSN
0803-5253
DOI
10.1111/apa.17554
language
English
LU publication?
yes
id
7993dfbc-0a28-4482-9497-725c1df611e4
date added to LUP
2025-01-28 14:31:30
date last changed
2025-07-16 03:55:58
@article{7993dfbc-0a28-4482-9497-725c1df611e4,
  abstract     = {{<p>Aim: To audit adherence to the Swedish paediatric guidelines for urinary tract infections (UTIs) in infants. Secondary objectives were to compare findings on imaging performed according to the guidelines with imaging without guideline support and to identify predictors of non-adherence. Methods: A prospective multicentre study of infants &lt;1 year treated at paediatric hospitals for their first UTI. Adherence to recommendations was assessed for diagnosis, treatment, and imaging of the urinary tract with a follow-up period of 1 year. Vesicoureteral reflux on voiding cystourethrography and findings on renal scintigraphy according to recommendations were compared to imaging without recommendation. Results: A total of 1357 infants were included. Adherence to recommended diagnostic procedures, antibiotic treatment, and imaging was 86.1%, 91.0% and 64.2%, respectively. Non-adherence to imaging recommendations was associated with inpatient management and smaller hospitals but was also more often due to excessive rather than refrained imaging. Conclusion: High adherence rates to diagnostic and treatment recommendations indicate careful attention to infant UTI among paediatricians. Lower adherence to imaging recommendations raises concerns regarding the guideline algorithm; particularly, early DMSA scans seem to be challenging for smaller hospitals.</p>}},
  author       = {{Lindén, Magnus and Rosenblad, Therese and Hansson, Sverker and Brandström, Per}},
  issn         = {{0803-5253}},
  keywords     = {{adherence; clinical guidelines; infant; urinary tract infection}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Paediatrica, International Journal of Paediatrics}},
  title        = {{Adherence to the Swedish paediatric guidelines for urinary tract infections}},
  url          = {{http://dx.doi.org/10.1111/apa.17554}},
  doi          = {{10.1111/apa.17554}},
  year         = {{2024}},
}