Antibiotics to kill the bacteria are used in the treatment of UTI. Oral antibiotics are used for older children who are otherwise fairly well. Children especially young babies, who are unwell, are often admitted to hospital for more aggressive and effective antibiotic treatment by injecting the antibiotics directly into the blood stream through a drip or what is termed intravenous antibiotic treatment.
Intravenous antibiotic is converted to oral antibiotic when the fever has settled for 24 hours and when the child’s condition has improved. The choice of antibiotics is based on the urine culture result, which will show the most appropriate antibiotic to be used.
The whole course of treatment for UTI usually lasts 14 days. After which a low nightly dose of antibiotics (prophylactic or preventive antibiotics) may be continued in young babies, till further review by doctors.
Children with UTI will require regular reviews with the doctor after discharge. Imaging studies of the urinary tract are also necessary to assess if there are any underlying abnormalities. Such studies include: ultrasound of the kidneys and the urinary tract, a kidney scan called DMSA scan, and a special radiological study called Micturating Cystourethrogram (MCU).
Parents need to remember that their child must complete the full course of antibiotics after discharge. Some children may need to continue treatment with a small nightly dose of antibiotic to prevent recurrent UTI while waiting to have further tests done. This small dose of antibiotic is safe and will have no long-term adverse effect on the child’s health.
There is a possibility that the child might get another UTI even if the child is on a small dose of preventive antibiotic. If the child develops any symptoms suggestive of a UTI as mentioned earlier or is unwell with a fever with no other obvious cause, please bring the child to the doctor for a urine test as soon as possible.
Good hygiene practices, avoiding constipation, going to toilet regularly to empty the bladder and adequate fluid intake are some measures that may help deter UTI.
Most children make very good recovery after UTI and have no further problems. In a small group of patients, scars may form in the kidneys, which can give rise to high blood pressure, and require long term monitoring and follow-up.
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