Evidence behind the WHO Guidelines: Hospital Care for Children: What is the Appropriate Empiric Antibiotic Therapy in Uncomplicated Urinary Tract Infections in Children in Developing Countries?

Abstract

Urinary tract infection (UTI) is an important cause of morbidity and mortality in children. Studies from developing countries show that the around 10% of children with febrile illnesses have UTI [8]. Studies have shown a higher UTI prevalence of 8-35% in malnourished children. The risk of developing UTI before the age of 14 is ~1% in boys and 3-5% in girls. Due to lack of overt clinical features in children less than 2 years appropriate collection of urine samples and basic diagnostic tests at first-level health facilities in developing countries UTI are not generally reported as a cause of childhood mortality. If poorly treated or undiagnosed UTI is an important cause of long-term morbidities such as hypertension failure to thrive and end-stage renal disease. Unfortunately many of the organisms responsible for UTI in developing and industrialized countries have become resistant to first-line antimicrobials. It is thus necessary to establish the type of pathogen and antimicrobial sensitivities in the local environment in order to treat the UTI with the appropriate antibiotic. (excerpt)