flashcards_uti
What is the initial investigation for a urinary tract infection (UTI)?
Initial investigation includes a full sepsis screen, including urine microscopy, culture, and sensitivity (MC&S).
What is the management for systemically stable children under 3 months with a UTI?
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.
What should be done for children aged 3 months to 15 years who are at high risk of serious illness?
Refer urgently to secondary care.
What oral antibiotics are recommended for lower UTI in children aged 3 months to 15 years?
Trimethoprim or nitrofurantoin (if eGFR ≥ 45 ml/min).
What antibiotics are recommended for upper UTI or acute pyelonephritis in children aged 3 months to 15 years?
Cephalexin or co-amoxiclav (only if culture results confirm the organism is susceptible).
What should be done for children with recurrent UTIs?
Refer all children to a paediatric specialist for further investigation.
What further investigations are needed for children with recurrent UTIs?
Follow up with ultrasound scans, Micturating cystourethrogram (MCUG), and DMSA scans to check for scarring and reflux.
