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Diagnosis and treatment of urinary tract infections in children

Riham Mohamed Arnous

Acute tract infections are relatively common in children, with eight percent of women and a couple of percent of boys having a minimum of one episode by seven years aged. The foremost common patho-gen is Escherichia coli, accounting for about 85 percent of tract infections in children. Renal parenchymal defects are present in three to 15% of youngsters within one to two years of their first diagnosed tract infection. Clinical signs and symptoms of a tract infection depend upon the age of the kid , but all febrile children two to 24 months aged with no obvious explanation for infection should be evaluated for tract infection (with the exception of circumcised boys older than 12 months). Evaluation of older children may depend upon the clinical presentation and symptoms that time toward a urinary source (e.g., leukocytes esterase or nitrite present on dipstick testing; pyuria of a minimum of 10 white blood cells per high-power field and bacteraemia on microscopy). Increased rates of E. coli resistance have made amoxicillin a less acceptable choice for treatment, and studies have found higher cure rates with trimethoprim/sulfamethoxazole. Other treatment options include amoxicillin/clavulanate and cephalosporins. Prophylactic antibiotics don't reduce the danger of subsequent tract infections, even in children with mild to moderate reflux. Constipation should be avoided to assist prevent tract infections. Ultrasonography, cystography, and a renal cortical scan should be considered in children with tract infections. (Am Fam Physician. 2011; 83(4):409-415.Copyright © 2011 American Academy of Family Physicians).