Urinary Tract Infection in Children: Diagnosis, Treatment and Long-term Management

Excerpt

In the past 30–50 years, the natural history of urinary tract infection (UTI) in children has changed as a result of the introduction of antibiotics and improvements in health care. This change has contributed to uncertainty about the most appropriate and effective way to diagnose and treat UTI in children and whether or not investigations and follow-up are justified.

UTI is a common bacterial infection causing illness in children. It may be difficult to recognise UTI in children because the presenting symptoms and/or signs are non-specific, particularly in younger children. Urine collection and interpretation of urine tests in children are not easy and therefore it may not always be possible to unequivocally confirm the diagnosis.

Current management involving imaging, prophylaxis and prolonged follow-up has placed a heavy burden on NHS primary and secondary care resources. It is unpleasant for children and families, costly and based on limited evidence. The aim of this guideline is to lead to more consistent clinical practice by considering the importance of accurate diagnosis and the effectiveness of subsequent investigations and treatment (including surgical intervention) and follow-up in altering the outcome.