[Recommendations of the consensus conference "diagnostic and therapeutic management of urinary tract infection in childhood"].
The recommendations of the Consensus Conference "Diagnostic and Therapeutic Management of Urinary Tract Infection in Childhood" are presented. Selection of the most appropriate urine collection technique depends on the child's ability to control urination and the urgency of the diagnosis. Directives for the interpretation of the various parameters of urinalysis are offered with the recommendation that diagnosis of urinary tract infection be based on urine culture. The indication of hospitalization does not depend on the location of the urinary tract infection but on the severity of repercussions and the risk of complications. Guidelines for first choice and alternative antibiotic therapy for parenteral or oral administration are established, as well as recommendations for the choice of route, type of regimen and the duration of the treatment, based on the patient's level of risk. Routine antibiotic prophylaxis is not recommended in children with a normal urinary tract after a first episode of urinary tract infection or in those with low-grade vesicoureteral reflux; the indication of prophylaxis in patients with recurrent infections or with high-grade reflux must be individualized. The current strategy of routine use of diagnostic imaging tests should be substituted by another strategy in which the use of these tests is individualized, taking into account each patient's level of risk.
Ochoa Sangrador
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C
Servicio de Pediatría, Hospital Virgen de la Concha, Zamora, España. cochoas@meditex.es
Málaga Guerrero
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S
D000284:Administration, Oral; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002648:Child; D003937:Diagnosis, Differential; D004630:Emergencies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy / Q000652:urine; D014556:Urine / Q000382:microbiology
D000900:Anti-Bacterial Agents