Paediatric urinary tract infections
Children under 11 aet: 3% ♀ 1% ♂.
In neonates, M>F
Nonspecific (fever, crying, difficult to settle, vomiting)
Important to exclude structural anomalies.
Dipstix urine shows leukocytes, nitrates.
Confirm with clean catch for MCS: >105/ml.
For all children: US kidneys. Consider KUB
for obstruction. Prophylactic antibiotics for all until
<1 aet: DMSA, MCUG.
1–5 aet: if US abnormal, DMSA (renal scarring). If DMSA abnormal,
MCUG or MAG3 (looking for reflux).
Amoxycillin ×5/7 (or 10/7 if systemically unwell).
Prevent future UTI's:
- Drink lots of fluids
- Frequent micturition
- Double voiding
- Perineal hygiene
For recurrent UTI's or reflux:
- Mandatory urine cultures for every systemic illness
- Prophylactic antibiotics (trimethoprim)
Reimplantation of ureters if medical treatment fails.
If scarred kidneys, BP and U&E.
- US kidneys (monitor growth & scarring)
- renal function
- reflux stopped?