Acute pyelonephritis in children: antibiotic therapy depending on the clinical context.

Children over 2 years of age with complicated acute pyelonephritis or at risk of complications should first be treated with a parenteral antibiotic, for example ceftriaxone, for 2 to 4 days, then switched to oral antibiotic therapy for a total treatment period of 10 to 14 days, taking into account the results of antimicrobial susceptibility testing. First-choice antibiotic therapy, in the absence of known risk, is oral cefixime for 7 days to 10 days. Second-line treatments include amoxicillin plus clavulanic acid or co-trimoxazole, taking account of the results of antimicrobial susceptibility testing.