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Urinary Tract Infections in Childhood

(UTI in Childhood)

Definition

The urinary tract carries urine from the kidneys to the outside of the body. It includes the kidneys, bladder, and tubes that connect them. The tubes from the kidney to bladder are called ureters. The tube from the bladder to the outside of the body is called the urethra. A urinary tract infection (UTI) is an infection in any of these structures.
The Urinary Tract
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Causes

UTIs are caused by bacteria. The bacteria may enter the bladder or the kidneys.

Risk Factors

Factors that may increase your child's chance of a urinary tract infection include:

Symptoms

Symptoms include:

Diagnosis

The doctor will ask about your child's symptoms and medical history. A physical exam will be done. The doctor may also ask for a urine sample. Follow the doctor's directions on collecting your child's urine.
Your child's bodily fluids may need to be tested. This can be done with:
Imaging tests may be ordered if your child is a boy with a UTI or a girl after her second UTI. These infections may be associated with problems in the urinary tract. The test may include ultrasound or specialized scans and x-rays.

Treatment

Talk with your doctor about the best treatment plan for your child. Treatment options include:

Antibiotics

Antibiotics will help fight the bacteria that is causing the infection. Your child will most likely be given antibiotic pills or liquid to take by mouth. Finish the medication even if your child is feeling better.
Some severe infections may need to have antibiotics delivered by IV or an injection.

Fluids

Encourage your child to drink plenty of fluids. This will help to flush the bacteria out of the system. It will also decrease the concentration of the urine. This may make it more comfortable to urinate.

Pain and Fever Relief

UTIs can be uncomfortable and may cause fever. Your child's doctor may advise over-the-counter or prescription pain relievers.
Follow the instructions on the package.
Note—Aspirin is not recommended for children with a current or recent viral infection. Check with the doctor before giving your child aspirin.

Prevention

To help reduce your child's chances of a urinary tract infection:

RESOURCES

Family Doctor—American Academy of Family Physicians http://familydoctor.org

National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca

Health Canada http://www.hc-sc.gc.ca

References

American Academy of Pediatrics (AAP) clinical practice guideline on diagnosis and management of initial UTI in febrile infants and children aged 2 to 24 months. Pediatrics. 2011 Sep;128(3):595.

Urinary tract infection. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases%5Fconditions/hic%5FUrinary%5FTract%5FInfections. Accessed May 15, 2013.

Urinary tract infection (UTI) in children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 12, 2013. Accessed May 15, 2013.

Urinary tract infection (UTI) prevention. Cincinnati Children's Hospital Medical Center website. Available at: http://www.cincinnatichildrens.org/health/u/uti-prevention. Updated January 2010. Accessed May 15, 2013.

12/5/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections. Cochrane Database of Syst Rev. 2007;(4):CD003237.

11/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Craig JC, Simpson JM, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med. 2009;361(18):1748-1759.

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