[Oral antibiotic treatment of urinary tract infections in children]

Abstract

Urinary tract infection (UTI) is one of the most common bacterial infections in childhood. Empiric antibiotic therapy is guided by the clinical presentation, the patient's ability to take oral agents and the local resistance pattern of Escherichia coli (E. coli), the most common pathogen. Most children (with both upper and lower UTI) can safely be treated with oral antibiotics. We recommend pivmecillinam or amoxicillin-clavulanic acid as first-line empiric therapy for upper UTI. Amoxicillin and trimethoprim-sulfamethoxazole are no longer first-line oral agents due to increasing E. coli resistance to both drugs. For lower UTI nitrofurantoin is an excellent first choice. In Norway, lack of paediatric antibiotic syrups is a great challenge and we recommend that such formulations are introduced to the Norwegian market.