Pediatric urinary tract infections

Urinary tract infection in the pediatric population can lead to significant morbidity if not treated promptly and appropriately. All first infections may signify possible underlying anatomic or functional abnormality and require imaging of the lower and upper tracts. Accurate diagnosis of UTIs requires a properly collected quantitative urine culture. Treatment should be tailored to the pathogen as dictated by the urine culture sensitivities to minimize the development of multidrug-resistant organisms. Prophylactic agents should differ from the antibiotic used in the acute setting and preferably concentrated in the urinary tract, with minimal effects on the normal fecal flora. In the long term, patients with documented evidence of renal scarring should be followed up for signs of renal deterioration and hypertension.