Urinary tract infection in children

Abstract

Introduction: Up to 11.3% of girls and 3.6% of boys will have had a urinary tract infection (UTI) by the age of 16, and recurrence of infection is common. Vesicoureteric reflux is identified in up to 40% of children being investigated for a first UTI, and is a risk factor for, but weak predictor of, renal scarring.

Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatment of acute urinary tract infection in children; and of interventions to prevent recurrence? We searched: Medline, Embase, The Cochrane Library and other important databases up to December 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

Results: We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (short delays in treatment, immediate empirical, intravenous, longer courses, oral, prolonged delay, prophylactic, single dose); surgical correction of minor functional abnormalities; surgical correction of moderate to severe vesicoureteric reflux.