UTIs in Children

00:01 Let's take a moment to review urinary tract infection and special populations.

00:06 We'll start with urinary infection in children.

00:09 So in the first year of life.

00:11 Having a urinary tract infection is going to be more common in boys than in girls.

00:16 And typically this is going to be associated with congenital anomalies of the urinary tract.

00:22 After the first year of life, it's more frequent in girls than boys to present within urinary tract infection and most are going to present with acute cystitis.

00:32 Vesicle ureter reflux needs to be excluded in this particular population.

00:37 So it's going to be important to obtain a voiding cystourethrogram, ultrasonogram or CT scan.

00:43 Avoiding cystourethrogram is something that our urological colleagues do for our patients.

00:48 And essentially what they do is they insert a catheter into the bladder and insert radio contrast media and then they have the child void.

00:55 This way they can visualize any type of anatomical defects within the bladder the urethra and they can see if there's reflux of urine back into the kidneys.

01:03 We want to obtain these tests with the first episode of pyelonephritis in any boy or girl.

01:09 A UTI in a boy or a girl less than three years of age or if you have recurrent infections in a girl that's greater than 3 years of age.

01:17 The treatment for acute cystitis the same three to seven days with standard antimicrobials.

01:24 For pyelonephritis, it's going to be on the order of 10 to 14 days and that antimicrobial treatment has to be tailored for the urine culture and sensitivities.

01:32 Again, we want to avoid fluoroquinolones, in this case under the age of 16 because it has an effect on cartilaginous tissues.