UTIs

Question 1

What do you do in a child <3m presenting to GP with suspicion of a UTI

Answer 1

IMMEDIATELY send to HOSPITAL

Question 2

How do you manage a child <3m coming to hospital with UTI

Answer 2

ADMIT

+ antibiotics e.g. co-amoxiclaav 5-7days min

Question 3

What are features of pyelo

Answer 3

Bacteriuria, sx of UTI
Fever >38 degrees
Loin pain
More unwell than simple UTI

Question 4

Give example of an antibiotic regimen for pyelo

Answer 4

IV ceftriaxone + gentamicin 10 days > switch to oral once well enough

Question 5

How do you treat cystitis in a child, with no systemic symptoms

Answer 5

oral antibiotics e.g. trimethoprim for 3 days

Safety net: return if child still unwell after 3 days, encourage adequate fluid intake

Question 6

What are measures for preventing UTIs in children

Answer 6

• high fluid intake
• regular voiding
• complete bladder emptying
• treat / prevent constipation
• good perianal hygiene
• lactobacillus acidophilus

consider antibiotic prophylxis

Question 7

What do you do if single confirmed UTI in child <6m that responds to Abx

Answer 7

Urinary tract USS

Question 8

List the 7 features of an atypical UTI

Answer 8

• severely unwell
• septicaemia
• poor urine flow
• abdominal / bladder mass
• raised creatinine
• fails to respond to Abx
• non E coli

Question 9

How do you manage an atypical UTI

Answer 9

Urinary tract USS during episode

MCUG if <6m
DMSA 6m later if <3y

Question 10

What is a recurrent UTI

Answer 10

3+ episodes of cystitis

2+ episodes of pyelo

Question 11

How do you manage recurrent UTI

Answer 11

DMSA for all, 4-6 months later

Question 12

What defines a UTI on MC&S

Answer 12

> 10^5 colony forming units / mL

+

> 50 leukocytes