Monday, December 5, 2022

What Antibiotics Treat Uti In Babies

How Are Most Utis Diagnosed

Taking Care of Your Children : How to Treat a UTI in a Pediatric Patient

There are several ways that your physician can diagnose a UTI. To provide the best antibiotic treatment for UTI, he or she needs to determine the location of the infection and whether your UTI is complicated. He or she also needs to rule out other conditions that present similarly to UTI, such as vaginitis or certain sexually transmitted diseases.

Most UTIs are diagnosed via urine test. In some instances, your healthcare provider may also order blood cultures and a complete blood count. These test results will confirm the type of bacteria, virus or fungus thats causing the infection.

Bacteria is to blame for the vast majority of UTIs, and theyre treated using a wide range of antibiotics. In rarer cases, where a virus is behind the infection, antivirals such as cidofovir are prescribed. Fungal UTIs are treated with antifungals.

Are There Any Over

Over-the-counter antibiotics for a UTI are not available. You should see your doctor to have your symptoms evaluated.

Your provider may recommend an OTC product called Uristat to numb your bladder and urethra to ease the burning pain during urination. Uristat can be bought without a prescription at the pharmacy. A similar phenazopyridine product called Pyridium is also available.

Take phenazopyridine for only 48 hours, and be aware it may cause your urine to turn a brown, orange or red color which may stain fabrics or contact lenses. It may be best to not wear contact lenses while being treated with phenazopyridine.

Phenazopyridine is not an antibiotic and will not cure a UTI.

See also: Ratings of Urinary Anti-Infectives

What Antibiotics Are Used To Treat Bacterial Utis

Once your physician has determined the location of your UTI and whether its complicated, he or she will likely suggest an antibiotic for treatment. Infections in the lower urinary tract are typically treated with oral medication , while upper-tract UTIs usually merit intravenous antibiotics.

All antibiotics require a prescription. This is, in part, to avoid the potential for antibiotic misuse, which can result in your body forming a dangerous resistance to antibiotics. Its also a way to ensure that you visit a healthcare provider when you have symptoms. If left untreated, even an uncomfortable but harmless lower-tract UTI can become more severe, particularly if its allowed to travel further up the urethra and take up residence in your kidneys.

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How Are Utis Treated

UTIs are treated with antibiotics. After several days of antibiotics, your doctor may repeat the urine tests to be sure that the infection is gone. It’s important to make sure of this because an incompletely treated UTI can come back or spread.

If a child has severe pain when peeing, the doctor may also prescribe medicine that numbs the lining of the urinary tract.

Give prescribed antibiotics on schedule for as many days as your doctor directs. Keep track of your child’s trips to the bathroom, and ask your child about symptoms like pain or burning during peeing. These symptoms should improve within 2 to 3 days after antibiotics are started.

Encourage your child to drink plenty of fluids, but skip drinks that containe caffeine , such as soda and iced tea.

Most UTIs are cured within a week with treatment.

Do Cranberries Cure Utis

Drug therapy in uti in children

No home remedies for UTIs exist. Drinking water can help to flush the infection from your body faster, and keep you hydrated for example, but its not a cure.

Similarly, cranberries are not a UTI remedy, although theres limited proof suggesting compounds present in cranberries, including sulfuric acid, may decrease the likelihood of repeat UTIs in women because they prevent certain bacteria from latching onto the wall of the urinary tract.

Between cranberry juice, cranberry extract and various cranberry supplements, no cranberry products are any better or more effective than others, as none have been specifically studied. That said, if you do seek out cranberry juice, opt for unsweetened cranberry juice, not cranberry juice cocktail.

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How Are Utis Diagnosed

To diagnose a UTI, health care providers ask questions about what’s going on, do an exam, and take a sample of pee for testing.

How a sample is taken depends on a child’s age. Older kids might simply need to pee into a sterile cup. For younger children in diapers, a catheter is usually preferred. This is when a thin tube is inserted into the urethra up to the bladder to get a “clean” urine sample.

The sample may be used for a urinalysis or a urine culture . Knowing what bacteria are causing the infection can help your doctor choose the best treatment.

About Urinary Tract Infections In Children

Urinary tract infections in children are fairly common, but not usually serious. They can be effectively treated with antibiotics.

A UTI may be classed as either:

  • an upper UTI if it’s a kidney infection or an infection of the ureters, the tubes connecting the kidneys to the bladder
  • a lower UTI if it’s a bladder infection or an infection of the urethra, the tube that carries urine from the bladder out of the body

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What Is The Treatment For A Uti

Antibiotics are the main treatment for UTIs. Treatment is usually for 3 to 7 days. This depends on several factors, including how unwell your child is and whether they have underlying kidney problems.

Encouraging your child to drink more fluid may help. You can give pain relief if your child is in discomfort. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose.

The following babies and children with a UTI usually need to go to hospital for intravenous antibiotics :

  • young babies under 3 months of age
  • children who are very unwell

Your child’s symptoms should start to improve after 48 hours of antibiotic treatment.

Role Of Antimicrobial Prophylaxis

Urinary Tract Infections in Children (UTIs)

The effectiveness of antimicrobial prophylaxis in the prevention of UTI recurrence has been studied extensively. The RIVUR trial revealed that trimethoprim-sulfamethoxazole prophylaxis reduced the risk of UTI recurrence by 50%. Similar results were reported by another placebo-controlled, double-blind trial. Combined results of the RIVUR and the Careful Urinary Tract Infection Evaluation studies revealed that toilet-trained children with VUR and BBD exhibit the greatest benefit from antimicrobial prophylaxis. However, many other randomized studies have revealed either a sex-based or no beneficial effect with prophylaxis. In systematic reviews and meta-analyses, researchers have also reported mixed results, with some concluding that prophylaxis is effective, and others reporting that prophylaxis offers no or little advantage for the prevention of UTI recurrence., These variations in results have been attributed to significant differences in study designs, including patient inclusion and exclusion criteria. No study has demonstrated any beneficial effect of antimicrobial prophylaxis for the prevention of renal scarring, although one must add that none of these studies were powered to evaluate renal scarring as a primary study end point, and even a recent meta-analysis was likely underpowered to reveal an effect.

Collection of uncontaminated urine specimen for diagnosis so that patients do not receive an antibiotic for a false-positive urine culture result

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What Increases Your Risk

Risk factors of urinary tract infection include:

  • Abnormalities of the urinary tract, including kidney stones and other urinary obstructions. Structural or functional problems that limit the kidneys’ or the bladder’s ability to eliminate urine properly can increase the risk of UTIs. These problems may be present at birth or may develop soon after.
  • Infrequent urination, incomplete emptying of the bladder, or constipation. These patterns are common during toilet training and make it easier for bacteria to build up in the urine.
  • An uncircumcised penis. The foreskin can trap bacteria, which can then enter the urinary tract and cause infection.
  • Catheterization, which is used in a hospital when a child is unable to urinate on his or her own. Bacteria can enter the catheter and start an infection.
  • Previous UTIs. The risk for future infections increases with each additional infection.
  • History of UTI or the backward flow of urine from the bladder into the kidneys in a parent or sibling.

Infants and young children who have UTIs often have vesicoureteral reflux .

Who Else Has A Higher Risk Of A Uti

There are a handful of other factors that can boost your odds of developing a UTI. They include:

  • Uncontrolled or inadequately controlled diabetes
  • Certain forms of birth control, such as diaphragms that put pressure on the urethra
  • Being sexually active, particularly with a new partner
  • Anatomical abnormalities or blockages along the urinary tract, such as kidney stones
  • Enlarged prostate

Because UTIs are so common, theyre also subject to a greater spread of misinformation than other conditions. Contrary to myth, you cannot get a UTI from using tampons or sanitary napkins, wearing tight clothing, riding a bike, or failing to urinate after intercourse.

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Common Side Effects With Antibiotic Use

Each antibiotic is responsible for its own unique list of side effects, and the list is usually extensive. Be sure to discuss your individual antibiotic side effects with your healthcare provider. However, there are side effects that are common to most antibiotics, regardless of class or drug:

Related: Common Side Effects from Antibiotics, Allergies and Reactions

Recurrent Utis And Further Testing

UTI in Children: Symptoms and Home Remedies: Ultimate Guide

If youre experiencing recurrent UTIs, your doctor may want to get a better look to rule out the possibility of an obstruction. Exams used in these instances include:

  • An abdominal ultrasound, which uses ultrasound waves to produce an image of your urinary tract
  • IVP, or an X-ray image of your urinary tract enhanced by dye
  • A CT scan, which takes precise, detailed pictures of your urinary tract
  • Cystoscopy, where your physician inserts a tiny camera via your urethra so he or she can examine the bladder and/or get a tissue sample

UTIs are considered recurrent if you experience three infections within a 12-month period or two within six months.

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When Should You Call Your Doctor

Urinary tract infections in infants and young children need early evaluation and treatment. Call your doctor to make an appointment within 24 hours if your child has:

  • Urine that looks pink, red, brown, or cloudy or is foul-smelling.
  • Burning pain with urination.
  • Frequent need to urinate without being able to pass much urine.
  • Pain in the flank, which is felt just below the rib cage and above the waist on one or both sides of the back.
  • Vaginal discharge with urinary symptoms.
  • Symptoms similar to those of a previous UTI.

Call the doctor if your child isn’t feeling better within 48 hours after starting an antibiotic.

Prognosis For Uti In Children

Properly managed children rarely progress to renal failure unless they have uncorrectable urinary tract abnormalities. However, repeated infection, particularly in the presence of VUR, is thought to cause renal scarring, which may lead to hypertension and end-stage renal disease. In children with high-grade VUR, long-term scarring is detected at a 4- to 6-fold greater rate than in children with low-grade VUR and at an 8- to 10-fold greater rate than in children without VUR. The risk of scarring after recurrent UTI is as high as 25%, or 10- to 15-fold greater than that in children with only 1 febrile UTI however, few children will have recurrent febrile UTI.

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Suggestions That May Help Some Children

Parents often want to know what they can do to prevent UTIs. Not all UTIs can be prevented, but here are some suggestions that may help some children:

  • treat any constipation
  • encourage your child to go to the toilet regularly when they feel the need
  • encourage your child to sit properly on the toilet with their feet on a stool so that they empty their bladder completely
  • make sure your child drinks plenty of water with meals, and during hot weather
  • teach girls to wipe their bottoms from front to back rather than back to front

There is a suggestion in studies of UTI in boys that circumcision might slightly reduce the incidence of UTI. But the benefit is small. Most specialists would not recommend circumcision for this reason unless there are repeated UTIs which are causing major health problems.

Recurrent Utis In Children

Febrile Baby: Urinary Tract Infection (UTI) â Pediatrics | Lecturio

A small number of children have recurring UTIs. If your child’s had a UTI before, it’s important that both of you watch for the return of any associated symptoms.

Tell your GP about any symptoms as soon as possible so a diagnosis can be confirmed and treatment can begin.

If your child has a problem that increases their risk of UTIs, such as faulty valves that allow urine to flow the wrong way, they may be prescribed low-dose antibiotics as a long-term measure to prevent further infections.

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Treatment If The Condition Gets Worse Or Recurs

If your child’s urinary tract infection does not improve after treatment with antibiotics, your child needs further evaluation and may need more antibiotics. Your child may have a structural problem that is making the infection hard to treat. Or the cause of the infection may be different from the types of bacteria that usually cause UTIs.

If the infection spreads and affects kidney function or causes widespread infection , your child may be hospitalized. These complications are rare, but they can be very serious. Children with impaired immune systems, untreated urinary tract obstructions, and other conditions that affect the kidneys or bladder are at higher risk for complications.

If tests show a structural problem in the urinary tract that increases your child’s risk for recurrent UTIs, the doctor may consider preventive antibiotics.

Symptoms And Signs Of Uti In Children

In neonates, symptoms and signs of urinary tract infection are nonspecific and include poor feeding, diarrhea, failure to thrive, vomiting, mild jaundice , lethargy, fever, and hypothermia. Neonatal sepsis Neonatal Sepsis Neonatal sepsis is invasive infection, usually bacterial, occurring during the neonatal period. Signs are multiple, nonspecific, and include diminished spontaneous activity, less vigorous sucking… read more may develop.

Infants and children & lt 2 years with UTI may also present with poorly localizing signs, such as fever, gastrointestinal symptoms , or foul-smelling urine. About 4 to 10% of febrile infants without localizing signs have UTI.

In children > 2 years, the more classic picture of cystitis or pyelonephritis can occur. Symptoms of cystitis include dysuria, frequency, hematuria, urinary retention, suprapubic pain, urgency, pruritus, incontinence, foul-smelling urine, and enuresis. Symptoms of pyelonephritis include high fever, chills, and costovertebral pain and tenderness.

Physical findings suggesting associated urinary tract abnormalities include abdominal masses, enlarged kidneys, abnormality of the urethral orifice, and signs of lower spinal malformations. Diminished force of the urinary stream may be the only clue to obstruction or neurogenic bladder.

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History And Physical Examination

Clinical signs and symptoms of a UTI depend on the age of the child. Newborns with UTI may present with jaundice, sepsis, failure to thrive, vomiting, or fever. In infants and young children, typical signs and symptoms include fever, strong-smelling urine, hematuria, abdominal or flank pain, and new-onset urinary incontinence. School-aged children may have symptoms similar to adults, including dysuria, frequency, or urgency. Boys are at increased risk of UTI if younger than six months, or if younger than 12 months and uncircumcised. Girls are generally at an increased risk of UTI, particularly if younger than one year.3 Physical examination findings can be nonspecific but may include suprapubic tenderness or costovertebral angle tenderness.

Pediatric Outpatient Treatment Recommendations

UTI in Pregnancy

Antibiotic prescribing guidelines establish standards of care, focus quality improvement efforts, and improve patient outcomes. The table below summarizes the most recent principles of appropriate antibiotic prescribing for children obtaining care in an outpatient setting for the following six diagnoses: acute rhinosinusitis, acute otitis media, bronchiolitis, pharyngitis, common cold, and urinary tract infection.

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How Can Utis Be Prevented In Kids

Following these tips may prevent symptoms of UTI in children.

  • Encourage your child to use the bathroom when he or she has to go, rather than holding it.
  • Teach your child how to properly wipe, front to back, after going to the bathroom.
  • Buy your potty-trained child cotton underwear, which allows the area to dry properly.
  • Dress your child in loose-fitting clothes, because tight clothes can trap moisture.
  • Make sure your child drinks enough fluids each day, preferably water. Ask your doctor how many ounces your child needs. Babies consume what they need through breastmilk or formula.

With proper treatment of a UTI, most kids will feel better in a couple days. Learn signs, symptoms and how to treat UTI in kids from @Childrens.

What Is The Urinary Tract And How Does It Normally Work

The urinary tract is the kidneys, ureters, bladder, and urethra.

The kidneys filter and remove waste and water from the blood to produce urine. The urine travels from the kidneys down 2 narrow tubes called the ureters. The urine is then stored in the bladder.

When your child does a wee, urine flows out of the body through the urethra, a tube at the bottom of the bladder. The opening of the urethra is at the end of the penis in boys and in front of the vagina in girls.

Front view of the urinary tract

Side view of the female urinary tract

Side view of the male urinary tract

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Primary Outcome: Uti Recurrence

One study by Amodio et al was not included in the meta-analysis because of clinical heterogeneity because it was conducted in 1978 with a different antimicrobial resistance profile, compared with the more recent studies. In their study, Kantamalee et al included 21 patients < 2 months of age. All patients received a short duration of parenteral antibiotics, and the study was not included in the primary meta-analysis .

In the remaining 10 studies, UTI recurrence within 30 days was 1.9% . This ranged between 0.0% and 10.2% in individual studies . A total of 59 of 3480 infants had a UTI recurrence within 30 days after short parenteral treatment , and 47 of 1971 had a UTI recurrence within 30 days after longer courses. Infants who received 3 days of parenteral antibiotics had a similar odds of recurrence as those who received > 3 days . There was no significant heterogeneity of treatment effects noted between studies . A funnel plot did not reveal visual evidence of asymmetry .

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