Common sense at last--investigating urinary tract infections

The management of urinary tract infections (UTI) in children has been full of controversy and disagreement. The Archivist remembers the days of the requirements of two micturating cystourethrograms, abdominal X-rays, sometimes intravenous urograms, isotope scanning of the renal tract and recurrent ultrasound of kidney requests. Following up children with 3 monthly urine sample (often by bag urine sample), prophylactic antibiotics up to the age of 5 years of age and the occasional bilateral re-implantation of ureters was the practice of the day. We were in fear that vesico-uroteric reflux (VUR) with recurrent UTIs predisposed to long-term renal disease. The NICE guidelines, in 2007 really caused much discern and debate and changed the way we approached, what was these invasive and unnecessary recommendations for managing urinary tract infections and VUR. This is a common daily dilemma and thankfully we now have a more sensible and evidence based guideline. It still has a...

from Archives of Disease in Childhood current issue https://ift.tt/2VXELBI