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Published on: July 18, 2017

Pharmacotherapy of lower urinary tract infections and pyelonephritis in children

Albert Bensman1, Tim Ulinski

  • 1Service de Néphrologie Pédiatrique, Hôpital d'Enfants Armand Trousseau (APHP), 75012 Paris, France.

Expert Opinion on Pharmacotherapy
|August 12, 2009
PubMed

Insights

This review distinguishes urinary tract infections (UTIs) in children, emphasizing prompt antibiotic treatment for pyelonephritis and cystitis. Asymptomatic bacteriuria requires exceptional antibiotic use due to potential harm and resistance risks.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Urinary tract infections (UTIs) in children encompass acute pyelonephritis, acute cystitis, and asymptomatic bacteriuria.
  • Distinguishing these conditions is crucial for appropriate management.
  • Asymptomatic bacteriuria may not require antibiotics and carries risks of harm and bacterial resistance.

Purpose of the Study:

  • To review current treatment strategies for pediatric UTIs.
  • To highlight the importance of differentiating UTI subtypes.
  • To inform clinical practice regarding antibiotic use in children with UTIs.

Main Methods:

  • Literature review of pediatric UTI treatment guidelines and research.
  • Analysis of diagnostic criteria for pyelonephritis, cystitis, and asymptomatic bacteriuria.
  • Evaluation of antibiotic efficacy and risks in different UTI presentations.

Main Results:

  • Antibiotics are essential for treating acute pyelonephritis and acute cystitis.
  • Antibiotic use for asymptomatic bacteriuria should be exceptional due to potential adverse effects.
  • Early treatment of pyelonephritis is critical to prevent long-term renal complications like scarring.

Conclusions:

  • Accurate diagnosis and differentiation of pediatric UTIs are paramount for effective treatment.
  • Antibiotic stewardship is vital, particularly in cases of asymptomatic bacteriuria.
  • Treatment guidelines must be updated regularly based on local resistance patterns and healthcare economics.

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