LONG-TERM EFFECT OF A PROTOCOL FOR THE DIAGNOSIS AND TREATMENT OF URINARY-TRACT INFECTION

We evaluated the policy changes of 10 pediatric departments in the Friuli Venezia Giulia region following the implementation of a new protocol for the diagnosis and treatment of urinary tract infection. Clinical data concerning 1,059 infants and children with a first episode of urinary tract infection were recorded in three periods, before (A), during (B), and after (C) implementation of the protocol application. We observed a significant increase in the total number of urinary tract infections (288 in period A, 464 in C) from period A to C, with particular regard to pyelonephritis (36.8 % in period A, 64.3 % in C). As radiological investigations were carried out more frequently, there was a significant increase in the number of cases of vesicoureteral reflux recorded (from 23 in period A to 76 in period C). Finally, a better therapeutic approach was progressively achieved: errors in the choice of antibiotics and the duration of treatment have been almost completely avoided in period C. In our opinion, these results demonstrate a long-term improvement of pediatricians' awareness of this frequent pediatric pathology and their policies to control it.