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Urinary tract infection in children

James Larcombe1

  • 1NHSE Northern and Yorkshire, Sedgefield, UK.

BMJ Clinical Evidence
|July 8, 2011
PubMed

Insights

This systematic review examines treatments for childhood urinary tract infections (UTIs) and recurrence prevention. It found evidence on antibiotics, immunotherapy, and surgery for effective and safe interventions.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Evidence-Based Medicine

Background:

  • Urinary tract infections (UTIs) are common in children, affecting up to 11.3% of girls and 3.6% of boys by age 16.
  • Recurrent UTIs are frequent, with vesicoureteric reflux identified in up to 40% of children investigated for a first UTI.
  • Vesicoureteric reflux is a risk factor for, but a weak predictor of, renal parenchymal defects.

Purpose of the Study:

  • To systematically review the effects of treatments for acute urinary tract infections in children.
  • To evaluate the effectiveness of interventions aimed at preventing UTI recurrence in pediatric populations.

Main Methods:

  • A systematic review of medical literature was conducted, searching databases including Medline, Embase, and The Cochrane Library up to July 2009.
  • Included studies comprised systematic reviews, randomized controlled trials (RCTs), and observational studies.
  • Harms alerts from regulatory agencies like the US FDA and UK MHRA were also incorporated.

Main Results:

  • The review identified 25 studies meeting the inclusion criteria, encompassing various intervention types.
  • A GRADE evaluation was performed to assess the quality of evidence for different interventions.
  • Data were synthesized to provide information on the effectiveness and safety of evaluated treatments.

Conclusions:

  • The review presents findings on the effectiveness and safety of numerous interventions for pediatric UTIs and recurrence.
  • Interventions evaluated include various antibiotic regimens (oral, intravenous, prophylactic), immunotherapy, and surgical corrections for vesicoureteric reflux.
  • Information is provided for surgical correction of both minor functional abnormalities and moderate to severe vesicoureteric reflux.
Abstract

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