flashcards_uti

Question 1

What is the initial investigation for a urinary tract infection (UTI)?

Answer 1

Initial investigation includes a full sepsis screen, including urine microscopy, culture, and sensitivity (MC&S).

Question 2

What is the management for systemically stable children under 3 months with a UTI?

Answer 2

All should be admitted to hospital after a full sepsis screen and receive parenteral antibiotics (e.g., IV ampicillin and gentamicin or cefotaxime). Consider oral stepdown after clinical response and negative blood/CSF culture.

Question 3

What should be done for children aged 3 months to 15 years who are at high risk of serious illness?

Answer 3

Refer urgently to secondary care.

Question 4

What oral antibiotics are recommended for lower UTI in children aged 3 months to 15 years?

Answer 4

Trimethoprim or nitrofurantoin (if eGFR ≥ 45 ml/min).

Question 5

What antibiotics are recommended for upper UTI or acute pyelonephritis in children aged 3 months to 15 years?

Answer 5

Cephalexin or co-amoxiclav (only if culture results confirm the organism is susceptible).

Question 6

What should be done for children with recurrent UTIs?

Answer 6

Refer all children to a paediatric specialist for further investigation.

Question 7

What further investigations are needed for children with recurrent UTIs?

Answer 7

Follow up with ultrasound scans, Micturating cystourethrogram (MCUG), and DMSA scans to check for scarring and reflux.