Professional Documents
Culture Documents
FAYROUZ
Management
Simple UTI
above 3 months of age
If not suspect
resistant pathogens,
complicating factors
noncompliance
Duration of Treatment
IV – 2 weeks
Followed up oral -1 week
Follow up image in 2nd week:
Surgery : if renal abscess formed
Fungal UTI
Aim
Identify patients at high risk of renal damage,
Below one year age
Those with VUR or urinary tract obstruction or anomalies.
USG
MCU
Anatomy of kidney and urinary
VUR DMSA
tract
Anatomical details of
Kidney size, number and location,
bladder & urethra. renal parenchymal infection
hydronephrosis,
cortical scarring
urinary bladder anomalies
Postvoid residual urine.
IAP Guidelines
NICE GUIDELINES
Hydration
Frequent voiding
Avoid Constipation
Grades III to V
Antibiotic prophylaxis up to 5 yr of age. Consider surgery if breakthrough
febrile UTI.
Grades Treatment
1-3 Mostly resolves Follow up
3-5 If not resolved by 5 years Surgery
3-5 Renal scarring + Surgery
Any grade Breakthrough UTI Surgery
recurrent even with
prophylaxis
Any grade Deterioration of renal Surgery
function
Any grade Paraureteric Surgery
diverticulum+, duplex
system +
Surgical management
Michael M, Hodson EM, Craig JC, Martin S, Moyer VA. Short versus standard
duration oral antibiotic therapy for acute urinary tract infection in
children. Cochrane Database Syst Rev. 2003;(1):CD003966.
STUDIES AGAINST PROHYLAXIS
Conway PH, Cnaan A, Zaoutis T, Henry BV, Grundmeier RW, Keren R. Recurrent
urinary tract infections in children: risk factors and association with prophylactic
antimicrobials. JAMA. 2007;298(2):179–186.
Montini G, Rigon L, Zucchetta P, et al.; IRIS Group. Prophylaxis after first febrile
urinary tract infection in children? A multicenter, randomized, controlled, noninferiority
trial. Pediatrics. 2008;122(5):1064–1071.