An End in Sight: Shorter Duration of Parenteral Antibiotics in Neonates

* Abbreviations: GBS — : Group B Streptococcus UTI — : urinary tract infection Prescribing the appropriate duration of antibiotic therapy is at the top of mind for the Centers for Disease Control and Prevention, hospital systems, and individual providers alike because it has a resounding impact on antimicrobial resistance.1 In this month’s issue of Pediatrics , Desai et al2 have taken on the duration of parenteral antibiotics for infants ≤60 days old with bacteremic urinary tract infection (UTI). This is a critical piece of a complicated puzzle that not only includes minimum duration of parenteral antibiotic treatment but also involves bioavailability of antimicrobial agents in infants and total treatment duration, which includes parenteral and oral antibiotic therapy. They have written a methodologically sound multicenter study and propose that a short course of parenteral antibiotics is no less effective than a long course in infants ≤60 days old with bacteremic UTIs. This study uniquely affords granularity with respect to the patient population, including a physician’s documented clinical assessment providing information such as temperature, ill appearance, or presence of a known genitourinary condition, which allowed for ascertainment of critical clinical information that influenced management decisions. Ultimately, … Address correspondence to Hillary L. Copp, MD, MS, Department of Pediatric Urology, University of California, San Francisco, Mission Hall Global Health Sciences Building, 550 16th St, 6th Floor, Box 1695, San Francisco, CA 94143. E-mail: hillary.copp{at}ucsf.edu