Child Nephrol Urol. 1992;12(1):19-23.
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.
我们评估了弗留利-威尼斯朱利亚大区10个儿科部门在实施尿路感染诊断和治疗新方案后的政策变化。在方案应用实施前（A期）、实施期间（B期）和实施后（C期）这三个阶段记录了1059例首次发生尿路感染的婴幼儿和儿童的临床数据。我们观察到从A期到C期，尿路感染的总数显著增加（A期为288例，C期为464例），肾盂肾炎尤为明显（A期为36.8%，C期为64.3%）。由于放射学检查的频率增加，记录的膀胱输尿管反流病例数显著增加（从A期的23例增加到C期的76例）。最后，逐步实现了更好的治疗方法：在C期几乎完全避免了抗生素选择和治疗持续时间方面的错误。我们认为，这些结果表明儿科医生对这种常见儿科疾病的认识及其控制策略有了长期改善。
