The SCOUT Study: "Short Course Therapy for Urinary Tract Infections in Children"

This is an interventional treatment trial for Urinary Tract Infection focused on measuring antibiotic therapy, antimicrobial resistance, children, E.coli, K.pneumoniae, parent study, SCOUT Study, spectrum stool bacteria, stool culture, urinary tract infections Read More

Inclusion Criteria:

1. Age at randomization: at least two months (at least 36 weeks gestational age for subjects less than two years of age) to 10 years of age (120 months).
2. Confirmed UTI (Urinary Tract Infection) diagnosis.

3. Documented Clinical Improvement at Randomization.

   1. Afebrile: No documented temperature > / = 100.4 degrees Fahrenheit or 38 degrees Celsius (measured anywhere on the body) 24 hours prior to the enrollment visit

   2. Asymptomatic: report NONE of the following symptoms:

      • Symptoms for all children (ages two months to 10 years):

        • Fever (a documented temperature of at least 100.4 degrees Fahrenheit OR 38 degrees Celsius measured anywhere on the body)

          • dysuria

      • Additional symptoms for children > 2 years of age:

        • suprapubic, abdominal, or flank pain or tenderness OR
        • urinary urgency, frequency, or hesitancy (defined as an increase in these symptoms from pre-diagnosis conditions)

      • Additional symptoms for children > / = 2 months to 2 years of age:

        • poor feeding OR
        • vomiting

4. Only children who have been prescribed one of the four antibiotics for which a placebo is available will be eligible to participate.

   • TMP-SMX; Cefixime; Cefdinir or Cephalexin. (Note a child that received a one-time dose of I.M. or I.V. medication (i.e. in ER or clinic) prior to starting on the one of the four oral medications is eligible for enrollment)
5. Parental or guardian permission (informed consent) and if appropriate, child assent (if > / = seven years of age).

Exclusion Criteria:

1. A urine culture proven infection with a second uropathogen > 10,000 CFU/mL collected via suprapubic aspiration or catheter or > 50,000 CFU/mL collected via clean void.
2. A child hospitalized with a UTI that has the following: concomitant bacteremia associated with the UTI, urosepsis, or is in intensive care.
3. A child whose urine culture reveals an organism that is resistant to the initially prescribed antibiotic.
4. A child with a catheter-associated UTI.
5. A child with known anaphylactic allergies to the study products.
6. A child with phenylketonuria (PKU).
7. A child diagnosed with congenital anomalies of the genitourinary tract.
8. UTI in children with known anatomic abnormalities of the genitourinary tract other than VUR (Vesicoureteral reflux), duplicated collection systems, and hydronephrosis.
9. A child that is not able to take oral medications.
10. Previous surgery of the genitourinary tract (except circumcision in male children).
11. Presence of an immunocompromising condition (e.g., HIV, malignancy, solid-organ transplant recipients, use of chronic corticosteroids or other immunosuppressive agents).
12. Unlikely to complete follow-up (e.g. not available for the two follow-up study visits and the follow-up phone call).
13. A child with a known history of type I hypersensitivity of the study antibiotics to be prescribed .
14. Enrollment in another antibiotic study less than 30 days prior to enrollment visit.
15. Previous enrollment of individuals in this study.
16. Planned enrollment during this study coincides with enrollment in another therapeutic drug study (excluding vaccine).
17. A child with a history of UTI within the past 30 days.
18. A child with known Grade III-V VUR.
19. A child taking antibiotic prophylaxis for any reason.
20. A child who has started Day 6 of the originally prescribed antibiotic treatment.