The New American Academy of Pediatrics Urinary Tract Infection Guideline

Newman, Thomas B.

doi:10.1542/peds.2011-1818

Cited by 106 publications

(70 citation statements)

References 17 publications

(11 reference statements)

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“…La infección de vías urinarias en nuestro estudio fue más frecuente en el género femenino, acorde a los datos encontrados de infección de vías urinarias en la población general (18,19), esto indica que, a pesar de su condición de inmunosupresión, no hay un aumento de riesgo por género de sufrir IVU. No obstante, en el paciente inmunosuprimido la Escherichia coli sigue siendo el principal patógeno causante de infección de vías urinarias, seguido por Klebsiella pneumonie y Enterococcus faecalis (8), similar a los observado en nuestro trabajo.…”

Section: Discussionunclassified

“…Este hallazgo indica que un uroanálisis normal no es suficiente para descartar la infección urinaria durante un episodio de neutropenia (21), razón por la cual debe continuarse utilizando el urocultivo en la evaluación inicial de este tipo de pacientes. Así, solo cinco de los ocho episodios fueron detectados por anomalías en el EGO y urocultivo, lo que indica la necesidad de buscar este foco de infección por medio de búsqueda activa más allá de la valoración regular sino con seguimiento estricto en pacientes que no responden como se espera, sobre todo si se tiene en cuenta que tienen mayor riesgo de muerte o complicaciones severas (19).…”

Section: Discussionunclassified

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Urinary Tract Infection as a Predictor of Poor Prognosis in Pediatric Patients With Severe Febrile Neutropenia Related to Chemotherapy

Galvis¹,

Díaz‐Martínez²,

Ávila³

2017

JOSHA

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Section: Discussionunclassified

Urinary Tract Infection as a Predictor of Poor Prognosis in Pediatric Patients With Severe Febrile Neutropenia Related to Chemotherapy

Galvis¹,

Díaz‐Martínez²,

Ávila³

2017

JOSHA

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“…Low-dose, long-term prophylaxis is still being recommended in patients with high renal scarring risk (2,5,6,32). However, antimicrobials in prophylaxis may increase the risk of development of resistance (5,22,31,33).…”

Section: Graphic1 Gender Distribution Of Isolated Bacteria In the Urmentioning

confidence: 99%

“…Antibiotic therapy is generally initiated empirically because early treatment decreases the rate of morbidity resulting from UTIs (2,3). Although prophylactic antibiotic use for recurrent UTIs is decreasing nowadays, it still is in the use (4)(5)(6). However, antibiotic resistance has become an increasingly pressing problem in many countries.…”

Section: Introductionmentioning

confidence: 99%

Effect of Prophylactic Antibiotic Use in the Development of Antibiotic Resistance in Children with Recurrent Urinary Tract Infections

Karacı¹,

Karagöz²,

Örnek³

et al. 2017

Haseki

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Aim:Although prophylactic antibiotic treatment is still debatable, it is currently in use in recurrent urinary tract infections (UTIs). In the present study, we aimed to observe if prophylactic antibiotic use had any effect on the development of antibiotic resistance in patients with recurrent UTIs who we followed up in our clinic. Methods: The present study was performed on patients aged between one month and 16 years, who had recurrent UTIs, and were followed up by the Department of Pediatrics at Bülent Ecevit University Medical School. Patient files were retrospectively reviewed, and 50 patients who received antibiotic prophylaxis and 100 patients without prophylaxis were enrolled in the study. Urinary tests, subsequent urinary culture results, and antibiotic resistances were compared between the groups. Results: The mean age was 42.7±44.2 months. The most frequently cultured isolated bacterium was Escherichia coli (E. coli) (58.4%). No difference was determined in bacteria in cultures between prophylaxis receivers and non-receivers. Isolation rate of E. coli was higher in urinary cultures in females than in males (p<0.001). When antibiotic resistance of all urinary culture-isolated bacteria was compared between the two groups, there was no statistically significant difference. However, an increased resistance against amoxicillin/clavulanic acid, ceftriaxone, and piperacillin was determined in prophylaxis group in whom E. coli was grown. In this study, general antibiotic resistance was most frequently observed against ampicillin (71.9%). Conclusion:In the present study, we observed that prophylaxis did not contribute so much to resistance other than E. coli. We recommend not preferring antibiotics which have increased resistance in our institution especially in children receiving prophylaxis for empirical treatment. Keywords: Childhood, urinary tract infection, prophylaxis, antibiotic resistance Amaç: Tekrarlayan idrar yolu enfeksiyonlarında (İYE) antibiyotik proflaksisi günümüzde tartışmalı da olsa kullanılmaya devam edilmektedir. Biz bu çalışmada, kendi kliniğimizde takip ettiğimiz tekrarlayan İYE'de kullanılan profilaksinin antibiyotik direnç gelişimine etkisinin olup olmadığını gözlemlemeyi amaçladık. Yöntemler: Bu çalışma Bülent Ecevit Üniversitesi Tıp Fakültesi Pediatri Departmanı'nca takip edilen bir ay ile 16 yaş arası tekrarlayan idrar yolu enfeksiyonu olan hastalarda yapılmıştır. Hasta dosyaları retrospektif olarak taranarak antibiyotik proflaksisi alan 50 ve almayan 100 hasta çalışmaya dahil edildi. Hastaların idrar tetkikleri, sonraki kültürlerindeki üremeleri ve bunların antibiyotik dirençleri gruplar arasında karşılaştırıldı. Bulgular:Hastaların %43,3 erkek, %56,7 kızlardan oluşmaktaydı ve ortalama yaşları 42,7±44,2 ay (1 ay-16 yaş) idi. Tüm kültürlerde en sık üreyen bakteri %58,4 ile Escherichia Coli (E. coli) idi. Profilaksi alan ve almayan gruplar arasında kültürde üreyen bakterilerin dağılımı açısından bir fark saptanmadı. Kızlardaki idrar kültürlerinde E. coli görülme oranı erkeklerden daha...

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“…In the recent guidelines for the diagnosis and management of urinary tract infections (UTI) in children, the American Association of Pediatrics recommend performing a post-UTI sonography, and if there are abnormal findings, a voiding cystourethrogram [1]. This change derives from the understanding that we should be avoiding renal damage rather more than diagnosing reflux, since both surgery and antibiotic prophylaxis are progressively being abandoned for most cases of vesicoureteral reflux (VUR) [2,3].…”

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confidence: 99%

Children with abnormal DMSA nuclear scan present a higher risk of recurrent febrile urinary tract infections

et al. 2018

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The ideal management of a child presenting a first episode of febrile urinary tract infection is still under debate. In the recent guidelines for the diagnosis and management of urinary tract infections (UTI) in children, the American Association of Pediatrics recommend performing a post-UTI sonography, and if there are abnormal findings, a voiding cystourethrogram [1]. This change derives from the understanding that we should be avoiding renal damage rather more than diagnosing reflux, since both surgery and antibiotic prophylaxis are progressively being abandoned for most cases of vesicoureteral reflux (VUR) [2,3]. The most significant event which will bring a child to active management is recurrence of UTI [4,5]. It seems therefore more clinically relevant to differentiate between children who will suffer recurrent episodes of UTI and those who will not, rather than to simply identify which children have VUR. We therefore aimed to evaluate if DMSA nuclear scan could reliably identify which children were at risk of presenting a second febrile UTI.We retrospectively analyzed all children aged between 2 and 24 months, without prenatally diagnosed uropathy, who were admitted to our institution for a first febrile UTI between 2009 and 2013, had a post-urinary tract infection sonography and DMSA nuclear scan, and were followed for at least 24 months. We excluded patients with missing or incomplete data, or lost to follow-up. Febrile UTI was defined as fever > 38 °C associated with positive urinalysis and urine culture (> 10 5 CFU/mL urine) collected through catheterization in girls, and clean-catch in boys. We noted patient's characteristics, and the results of the DMSA scan performed within 1 month of the acute episode. DMSA scans were categorized as normal, i.e., no scarring or dysplasia, or abnormal, any degree of scarring or dysplasia, functional impairment or atrophy.After the first febrile UTI, parents were systematically counseled about early diagnosis and having a urinalysis done if their child presented unexplained fever. None were given antibiotic prophylaxis but they were given advice about local hygiene and measures to avoid constipation in their child. All children were followed at least once every 6 months for a minimum of 24 months. The main outcome was recurrence of a second febrile UTI within the first 24 months of follow-up. In case of recurrence, a cystogram was performed, and children were further managed accordingly.On hundred and seven children were included in our study. There were 49 boys and 58 girls (45.8/54.2%). None were lost to follow-up, and all relevant data were available for all included patients. Children included did not differ from those who were excluded from the study. The mean age at first febrile UTI was 6.8 ± 5.4 months. Twenty-four (22.4%) children presented abnormal DMSA findings. Six presented asymmetric function without signs of dysplasia or scarring, two had a solitary kidney, and 16 had signs of dysplasia or scarring, of which 6 had asymmetric function. Sixteen (14.9%)...

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The New American Academy of Pediatrics Urinary Tract Infection Guideline

Cited by 106 publications

References 17 publications

Urinary Tract Infection as a Predictor of Poor Prognosis in Pediatric Patients With Severe Febrile Neutropenia Related to Chemotherapy

Urinary Tract Infection as a Predictor of Poor Prognosis in Pediatric Patients With Severe Febrile Neutropenia Related to Chemotherapy

Effect of Prophylactic Antibiotic Use in the Development of Antibiotic Resistance in Children with Recurrent Urinary Tract Infections

Children with abnormal DMSA nuclear scan present a higher risk of recurrent febrile urinary tract infections

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