A multicenter prospective trial has investigated whether oral antibiotic treatment is as effective at minimizing renal scarring as sequential intravenous(IV)/oral therapy in infants and children with pyelonephritis. 171 children aged 1–36 months with a first episode of pyelonephritis received either oral cefixime for 10 days or IV ceftriaxone for 4 days followed by oral cefixime for 6 days. Follow-up scintigraphy showed renal scarring in 30.8% of children in the oral treatment group, but in only 27.3% of the sequential group. This finding supports the use of oral therapy for primary episodes of pyelonephritis in young children and infants.