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Master Thesis

Étude descriptive sur la prise en charge des pyélonéphrites aigües de l'enfant au CHU de Grenoble durant l'année 2011‎ : évaluation des pratiques professionnelles confrontées aux recommandations

Abstract : Acute pyelonephritis is a frequent bacterial paediatric infection. The management is not consensual. We carried out an observational study focused on 342 hospitalised children for acute pyelonephritis during 2011 at the Grenoble hospital center, in order to evaluate our management. Urinary collection is performed on bag, but with an unacceptable rate of false positives. Priority should be given to suprapubic puncture and urinary catheterization, despite any difficulties of realisation. Blood culture ought to be performed more systematically, for an adaptation of the duration of parenteral antibiotherapy. Renal echography should be performed within short time in order to invalidate certain diagnosis, detect any severe forms and urological problems. We have to respect diagnostic criteria, for the 7.3% patients who do not show urinary tract infection the diagnosis should have been invalidated. Hospitalisations exceed recommendations. Short duration hospitalisation and ambulatory intravenous treatment should be performed more frequently. Prescription of aminoglycosides exceeds indications. It seems precautions must be taken when reading the creatinine values, to be compared with the regular values depending on age or the GFR calculation, to adapt aminoglycosides dose. Treatment duration should be respected. More than 50% treatment durations are higher than 14 days. The treatment begins with parenteral treatment then oral relay, taking into account the resistances and ESBL emergence. Prophylactic antibiotic and cystography indications should be discussed case by case. Following this study, a new protocol will be proposed, in order to respect at best the data of the literature.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00833346
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Submitted on : Wednesday, June 12, 2013 - 2:55:22 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
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  • HAL Id : dumas-00833346, version 1

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Maud Gerin. Étude descriptive sur la prise en charge des pyélonéphrites aigües de l'enfant au CHU de Grenoble durant l'année 2011‎ : évaluation des pratiques professionnelles confrontées aux recommandations. Médecine humaine et pathologie. 2013. ⟨dumas-00833346⟩

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