who received a second-generation cephalosporin, had a reaction, whereas 5.5% (4 of 73 patients) of those patients given only a first-, third-, and fourth-generation cephalosporin reacted (p < 0.04).

Current guidelines recommend that children with acute pyelonephritis are initially treated with a parenteral third-generation cephalosporin such as ceftriaxone, and then oral antibiotics.