Antibiotic prophylaxis for childhood urinary tract infection: A national survey
Bibliographic record
Abstract
AIMS: To describe attitudes of paediatricians and paediatric nephrologists regarding antibiotic prophylaxis for urinary tract infection (UTI) and determine the factors associated with its use. METHOD: A self-administered questionnaire was mailed to Canadian paediatricians (1136) and paediatric nephrologists (42). RESULTS: The response rate was 58.1% (684 physicians); 436 who had made a decision about antibiotic prophylaxis for childhood UTI in the previous year were included in the analysis. Of these, 407 (93.3%) were certified in paediatrics and 29 (6.7%) were paediatric nephrologists. Most respondents prescribed prophylaxis for children with grade III-V vesicoureteral reflux (VUR) (96.5%-98%); 69.8 and 92.8% prescribed it for children with grades I and II VUR, respectively. Factors significantly associated with use of prophylaxis for children with grade I VUR were frequency of decision-making about prophylaxis, city size and province. Fifteen percent of physicians felt that their practice regarding antibiotic prophylaxis for children with VUR was evidence based. A hundred one respondents (24.3%) prescribed prophylaxis for infants with a first febrile UTI in the absence of VUR. Nineteen percent felt that their practice regarding antibiotic prophylaxis for these infants was evidence based. Prescription of prophylaxis for children >12 months with recurrent UTI in the absence of VUR was influenced by frequency of pyelonephritis (88.5% of respondents) and presence of voiding dysfunction (53.8%). Nine percent of physicians felt that their practice for these children was evidence based. CONCLUSION: Opinions of Canadian paediatricians and paediatric nephrologists regarding antibiotic prophylaxis for UTI in children vary widely, probably because of the paucity of solid evidence about prophylaxis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".