Urinary Tract Infection

Incidence:

  • Until 3months old more common in boys (due to congential abnormalities)
  • After 3 months more common in girls.
  • 8% boys and 2% of girls will have UTI in childhood

Presentation – depends on age

Infants: poor feeding, vomiting, irritability

Young Children: abdominal pain, fever, dysuria

Older Children: dysuria, frequency, haematuria

Symptoms which may suggest Upper UTI include:

  • Temp > 38C
  • Loin pain / tenderness

NICE guidelines for checking urine:

  • If there are any symptoms/signs of UTI
  • Unexplained fever of 38C or higher (test urine after 24hours at latest)
  • With an alternative site of infection but who remain unwell (consider test after 24hours at the latest)

Urine collection method

  • clean catch if possible
  • if not possible then urine collection pads should be used
  • cotton wool balls, gauze and sanitary towels are not suitable
  • invasive methods such as suprapubic aspiration should be avoided if possible

Management of UTI in kids

  • If less than 3months –> refer to paeds immediately
  • If more than 3 months:
    • with upper UTI – consider admission
    • if not admitted – oral antibiotics such as cephalosporin or co-amoxiclav – give for 7 – 10 days
    • Lower UTI 3 days of oral antibiotics(according to local guidelines – usually trimethoprim or amox)
    • Parents told to return if child remains sick after 24-48hours
  • antibiotic prophylaxis is not given after the first UTI but should be considered after recurrent UTIs.