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Review
. 2020 Feb;109(2):236-247.
doi: 10.1111/apa.14988. Epub 2019 Oct 6.

Updated Italian recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children

Anita Ammenti  1 , Irene Alberici  2 , Milena Brugnara  3 , Roberto Chimenz  4 , Stefano Guarino  5 , Angela La Manna  5 , Claudio La Scola  6 , Silvio Maringhini  7 , Giuseppina Marra  8 , Marco Materassi  9 , William Morello  8 , Giangiacomo Nicolini  10 , Marco Pennesi  11 , Lorena Pisanello  12 , Fabrizio Pugliese  13 , Floriana Scozzola  14 , Felice Sica  15 , Antonella Toffolo  16 , Giovanni Montini  8   17 ; Italian Society of Pediatric Nephrology
Affiliations
Review

Updated Italian recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children

Anita Ammenti et al. Acta Paediatr. 2020 Feb.

Abstract

Aim: Our aim was to update the recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children, which were endorsed in 2012 by the Italian Society of Pediatric Nephrology.

Methods: The Italian recommendations were revised on the basis of a review of the literature published from 2012 to October 2018. We also carried out an ad hoc evaluation of the risk factors to identify children with high-grade vesicoureteral reflux or renal scarring, which were published in the previous recommendations. When evidence was not available, the working group held extensive discussions, during various meetings and through email exchanges.

Results: Four major modifications have been introduced. The method for collecting urine for culture and its interpretation has been re-evaluated. We have reformulated the algorithm that guides clinical decisions to proceed with voiding cystourethrography. The suggested antibiotics have been revised, and we have recommended further restrictions of the use of antibiotic prophylaxis.

Conclusion: These updated recommendations have now been endorsed by the Italian Society of Pediatric Nephrology and the Italian Society for Pediatric Infectivology. They can also be used to compare other recommendations that are available, as a worldwide consensus in this area is still lacking.

Keywords: antibiotic treatment; children; febrile urinary tract infection; prophylaxis; vesicoureteral reflux.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Treatment of urinary tract infection
Figure 2
Figure 2
When should imaging to detect vesicoureteral reflux be performed? Legends: SFU, Society for foetal Urology; VCUG, fluoroscopic contrast voiding cystourethrography; RNC, direct radionuclide cystography; CEVUS, contrast enhanced voiding ultrasonography
See this image and copyright information in PMC

References

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