Abstract
Urinary Tract Infections (UTIs) are a common occurrence in paediatrics. UTIs present in children as fever, anorexia, vomiting, lethargy and dysuria. Approximately 80% of the time, Escherichia coli is the causative bacteria in paediatrics, however, fungal UTI caused by Candida species can occur in premature infants. With an estimated 150 million UTIs occurring worldwide annually, this paper aims to establish the ideal management of urinary tract infections in paediatrics. Clinical signs and symptoms of UTI in paediatrics are dependent on age of the child. Neonates (0–27 days old) present with sepsis, vomiting, fever, and prolonged jaundice, while school aged children present with symptoms similar to adults such as dysuria and urgency. Diagnosis of a UTI can be done by using a urine dipstick or using the midstream clean catch method in toilet trained children, and using the transurethral catheterisation or suprapubic aspiration method for infants and young children. In the wake of antibiotic resistance, choosing the best anti-microbial agent for treatment is imperative. Whilst asymptomatic bacteriuria does not require antibiotic treatment, amoxicillin and clavulanic acid combination, cephalexin, cefixime and cefpodoxime are the preferred oral antibiotics, provided there are no known allergies. Ceftriaxone, ampicillin, cefotaxime and gentamycin are the recommended parenteral antibiotics, provided age, allergic status and renal function are considered prior to use. Careful consideration needs to be given before using prophylaxis in UTIs and should be reserved for extreme cases.
Highlights
Urinary Tract Infections (UTIs) are usually caused by gram-negative aerobic bacilli; approximately 80% are caused by Escherichia coli.[2,4]
Supportive treatment like paracetamol together www.tandfonline.com/oemd 19 The page number in the footer is not for bibliographic referencing with non-pharmacological advice, such as good hygiene and adequate hydration, can reduce the discomfort for the patient
Summary
Urinary tract infection (UTI) is defined as a significant growth of bacteria in the urine, together with fever, lethargy, dysuria, pain, anorexia, vomiting and possible kidney scarring.[1,2,3] UTIs are usually caused by gram-negative aerobic bacilli; approximately 80% are caused by Escherichia coli.[2,4] Other causative enterobacteria include Enterobacter, Citrobacter, Proteas, Providencia, Morganella and Serratia.[4] Proteus is common in boys and in children with renal stones.[5] Coagulase-negative Staphylococci have been isolated.[5] Premature infants can develop a fungal UTI, usually caused by Candida species.[4]
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