Prevalence of urinary tract infection in children of preschool age

Abstract

In view of the uncertainty regarding the effect of treatment on the long-term prognosis of children with asymptomatic bacteriuria, it is suggested that the results of controlled studies should be awaited before any recommendation is made concerning the urinary screening of this age group.

Renal scarring and vesicoureteric reflux.

“…Community screening programmes have been directed mainly at schoolgirls (Savage et al, 1973;Asscher et al, 1973;Edwards et al, 1975), and only small numbers of preschool children have been investigated (Davies et al, 1974;Boothman et al, 1974;Kunin et al, 1976). The study of Boothman et al (1974) suggests that bacteriuria is byno means rare in boys under 5 years, in contrast to older boys (Kunin et al, 1962;Meadow et al, 1969). Moreover, our findings, like those of MacGregor and Freeman (1975) and , show at least as many infant boys as girls with reflux severe enough to be potentially damaging.…”

The authors reply as follows

“…The high incidence of significant bacteriuria in small boys in our study is indeed surprising but there is little to suggest the possibility of false positive cultures except, perhaps, in Case 6 (Table V) (Boothman, Laidlaw, and Richards, 1974). When investigated at the renal clinic, 4 of the 6 boys had positive cultures and these were confirmed in 3 cases by suprapubic aspiration.…”

“…Sir, The high prevalence of urinary tract infection reported in preschool children in Glasgow (Boothman, Laidlaw, and Richards, 1974) is interesting and also surprising. It contrasts with the lower prevalence found in a slightly larger Leeds survey published in the Lancet last year (Davies et al, 1974) and also a London survey (Saxena, Collis, and Laurance, 1975).…”

Amoxycillin and clavulanic acid in the treatment of urinary infection.

“…The peak serum concentrations for both amoxycillin and clavulanic acid occurred between 30 and 90 minutes after the oral administration of the tablets and the paediatric suspension-C2 tablets, mean (SD); amoxycillin 6-8 (5-3) mg/l, clavulanic acid 3-4 (3.2) mg/l: C2 suspension mean (SD); amoxycillin 9.7 (7) mg/l, clavulanic acid 4-4 (3-8) mg/l. In those taking C4 suspension, the serum concentrations were highest at 90 minutes (amoxycillin mean (SD); 7-5 C2 paediatric suspension Amoxycillin (125 mg) 9-4 (8-1) (0.7-23) 9-7 (7-0) (0.8-23) 6 (5.7) mg/I, clavulanic acid 3-7 (1-9) mg/i), but because of the timing of specimens the exact time of peak concentration could not be determined. High urinary concentrations of both drugs were maintained throughout the 0 to 6 hours collection period in all patients.…”

“…1-3 mths 2-0 ml C4* 5-(}8-4 3-9 mths 2-5 ml C4* 8-5-12-4 9 mths-2 yrs 5-0 ml C4* 125-18- 6 2-5 yrs 5-0 ml samples were taken at 30 minutes, 60 minutes, and 90 minutes thereafter. Urine was collected in timed samples from 0 to 6 hours.…”