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Urinary tract infection - children - Treatment

Alternative Names

UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children

Treatment:

In children, UTIs should be treated quickly with antibiotics to protect the kidneys. Any child under 6 months old or who has other complications should see a specialist right away.

Younger infants will usually stay in the hospital and be given antibiotics through a vein. Older infants and children are treated with antibiotics by mouth. If this is not possible, they are admitted to the hospital where they are given antibiotics through a vein.

It is important that your child drink plenty of fluids while they have a urinary tract infection.

Some children may be treated with antibiotics for long periods of time (as long as 6 months - 2 years). This treatment is more likely when the child has had repeat infections or a condition called vesicoureteral reflux, which causes urine to flow back up into the ureters and kidneys.

The health care provider may also recommend low-dose antibiotics after the first symptoms have gone away. This type of treatment is less common now than it once was.

Antibiotics commonly used in children include:

  • Amoxicillin or amoxicillin/clavulanic acid (Augmentin)
  • Cephalosporins
  • Doxycycline (should not be used in children under age 8)
  • Nitrofurantoin
  • Trimethoprim-sulfamethoxazole

Follow-up urine cultures may be needed to make sure that bacteria are no longer in the bladder.

Expectations (prognosis):

Most children are cured with proper treatment. The treatment may continue over a long period of time.

Long-term problems from repeated UTIs in children can be serious. However, these infections can usually be prevented.

Complications:

Calling your health care provider:

Call for an appointment with your health care provider if your child's UTI symptoms continue after treatment or come back more than twice in 6 months.

Call your health care provider if the child's symptoms get worse, or new symptoms develop, especially:

  • Back pain or flank pain
  • Bad-smelling, bloody, or discolored urine
  • Fever of 100.4°Fahrenheit (38°Celsius) rectally in infants, or over 101°Fahrenheit (38.3°Celsius) in children
  • Low-back pain or abdominal pain (especially below the belly button)
  • Persistent fever
  • Unusually frequent urination or frequent urination during the night
  • Vomiting
  • Reviewed last on: 8/4/2011
  • Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

White B. Diagnosis and treatment of urinary tract infection in children. Am Fam Physician. 2011;83:409-415.

Williams G, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in chidlren. Cochrane Database Syst Rev. 2011 Mar 16:(3):CD001534.

Craig JC, Simpson JM, Williams GJ, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med. 2009 Oct 29;361(18):1748-59.

Skoog SJ, Peters CA, Arant BS Jr, et al. Pediatric Vesicoureteral Reflux Guidelines Panel Summary Report: Clinical Practice Guidelines for Screening Siblings of Children With Vesicoureteral Reflux and Neonates/Infants With Prenatal Hydronephrosis. J Urol. 2010 Sep;184(3):1145-51.

Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D'Amico F, Hoberman A, Wald ER. Does this child have a urinary tract infection? JAMA. 2007;298:2895-2904.

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