Recurrent UTI in children

Definition of recurrent UTI in child

  • 3 lower UTIs
  • 2 upper UTIs (bacteruria + fever/loin pain)
  • 1 lower UTI + 1 upper UTI

 

Presentation of UTI varies depending on age

  • <3 months – fever, vomiting, lethargy, reduced feeding, faltering growth
  • 3 months -> 3 years – as above + abdo pain
  • >3 years – frequency, dysuria, cloudy urine

 

Collecting urine sample

  • Ideally clean catch, otherwise, urine collection bag

 

Refer for imaging

  • <6 months old and responds well to treatment -> USS
  • atypical/recurrent -> refer to paeds for further imaging (MCUG, DMSA)
    • (MCUG good for vesicoureteric reflux, DMSA good for kidney scarring)

 

Clinical management

  • <3 months old + unwell – admit
  • >3 months old – nitrofurantoin
  • Lifestyle
    • Hygiene
    • Increase fluids
    • Avoid constipation – easy access to toilets