What is the treatment for UTIs in children?
Antibiotic therapy for UTIs is based upon the sensitivity profile obtained from the urine-culture results. Cystitis (infection limited to the bladder) should respond quickly to routine oral antibiotics. Pyelonephritis may need hospitalization for intravenous administration of antibiotics along with fluid therapy if the patient is experiencing associated vomiting and dehydration. Oral antibiotic therapy, however, may be appropriate if these complications are not present.
The American Academy of Pediatrics has issued a position statement recommending follow-up studies for children who have experienced a urinary tract infection. Children who should be further evaluated include
- children 2 months of age to 2 years of age who sustain their first UTI,
- any male child who experiences a UTI,
- any child 3 years and older who has had more than one UTI, and
- any child who has had pyelonephritis.
The purpose of the studies detailed below is to accurately define the anatomy and functional physiology of these children who may be at risk for renal scarring and possible complete kidney failure.
- Renal ultrasound: This procedure helps to define the renal anatomy (kidney location, size, shape).
- VCUG (voiding cysto-urethrogram): This test involves passage of a catheter into the bladder to fill it with dye. After removal of the catheter, the bladder will empty. A radiologist performs imaging studies to monitor for complete bladder emptying without obstruction and/or backward flow (reflux) of the dye from the bladder into to ureters and up to the kidneys.
- Renal scan: This test uses a small amount of radioactive material (radioisotope) to measure the function of the kidneys. It is designed to evaluate the functional capability of the kidneys and evaluate for possible renal scarring.
- IVP (intravenous pyelogram): This is a rarely used test involving injecting dye into the bloodstream via an IV (The dye is excreted via the kidneys.) and then obtaining X-ray images. The renal ultrasound and renal scan have replaced the usefulness of this test.