SURVEY OF THE ATTITUDES TO MANAGEMENT OF ACUTE PYELONEPHRITIS IN CHILDREN

Although urinary tract infections are of particular concern in young c hildren, as they may lead to permanent health problems, there is no co nsensus for their acute management. We carried out a mailed survey of 455 general practitioners, 143 paediatricians (randomly selected from a list of physicians in the Rhone-Alpes region of France) and 45 paedi atric nephrologists (all the members of the ''Societe de Nephrologie P ediatrique'') to examine their attitudes to the management of a fictit ious case of a young girl with symptoms indicative of acute pyelonephr itis. The responses given by the general practitioners and paediatrici ans were similar, whereas those given by the paediatric nephrologists were often different, for example 20% of the general practitioners and 17% of the paediatricians said they would hospitalise the child, comp ared with 69% of the paediatric nephrologists. The majority of the gen eral practitioners and paediatricians favoured single oral antibiotic therapy, whereas the paediatric nephrologists were split between singl e and combined antibiotic therapy, but preferred intravenous administr ation. The most frequently prescribed drug was a penicillin. The heter ogeneity of the results from this survey stresses the need for the ass essment of various strategies in terms of their efficacy for preventin g kidney scarring and their risk-to-benefit ratios in well-designed ra ndomised controlled trials.