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S7-5
(PP)
OUTPATIENT MANAGEMENT OF PEDIATRIC UTI: RESOURCE UTILIZATION AND
OUTCOMES
Hillary COPP
1
, Janet HANLEY
2
, Christopher SAIGAL
3
and Kara SAPERSTON
4
1) University of California at San Francisco, Urology, San Francisco, USA - 2) RAND Corporation, Santa Monica, USA - 3)
University of California at Los Angeles, Urology, Los Angeles, USA - 4) St Lukes Mountain States Urology, Urology,
Boise, USA
PURPOSE
Most pediatric UTIs are treated in the outpatient setting. The goals of the present study were to describe the course of
outpatient UTI management and resource utilization.
MATERIAL AND METHODS
We analyzed all children <18 years old who had an antibiotic prescribed for an outpatient UTI from 2002-2010 using the
Truven Health MarketScan® Research Databases. We compared side effects of narrow vs. broad-spectrum antibiotic
treatment. Chi2 analysis was used for descriptive statistics.
RESULTS
We identified 242,819 outpatient, antibiotic-treated, UTI episodes. During the 21-day period following presentation
<20% required >1 visit for UTI management, <1% required hospital admission, and 6% had a renal bladder ultrasound.
34% were initially prescribed a broad-spectrum antibiotic. Antibiotic switching (change from empirically-prescribed
antibiotic to another antibiotic) occurred in only 8% of UTI episodes, indicating that empiric prescription covered the
offending uropathogen the majority of the time. Antibiotic side effects occurred in 9% of UTI episodes. The most
common side effects were gastrointestinal (~3% of UTI episodes). All other side effects occurred in <1% of UTI
episodes. Although there are statistically significant differences in side effects between broad versus narrow antibiotics,
these differences were not clinically relevant.
CONCLUSIONS
Most UTI episodes are safely and effectively managed in the outpatient setting with >80% requiring only one total visit
and >90% requiring no change in empiric antibiotic therapy. Approximately 10% of children treated for UTI will
experience an antibiotic side effect.