2012-04-01 Journal of Paediatrics and Child Health - Diagnosis and management of UTI in children

[Minuteman]

Williams, G. J., Hodson, E. H., Isaacs, D. and Craig, J. C. (2012), Diagnosis and management of urinary tract infection in children. Journal of Paediatrics and Child Health, 48: 296–301. doi: 10.1111/j.1440-1754.2010.01925.x Abstract available at http://onlinelibrary.wiley.com/doi/1...925.x/abstract

A young child presents to their primary health provider with fever and irritability. How likely is a urinary tract infection? How should a urine sample be collected? How accurate are urinary dipsticks and microscopy compared with culture for the diagnosis? What route and type of antibiotics should be used? What imaging is indicated? Diagnosing and treating children with urinary tract infection presents many questions. This review summarises the most relevant recent primary studies, systematic reviews and guidelines.

Further article excerpts (courtesy of Circumcision Information Australia):

approximately 20% of children who have had one UTI experience a symptomatic recurrence. Preventing UTI recurrence would avoid further episodes of illness, discomfort and family stress. The likelihood that preventing UTI would prevent clinically important kidney damage is unknown but likely to be very low, given the very low risk of clinically important kidney damage following UTI, and the modest benefit of prophylactic interventions.

The Royal Australasian College of Physicians’ policy position is that circumcision is not indicated as primary prevention. It could be estimated that between 110 and 140 circumcisions are required to prevent one UTI, while major complications occur in around 2%. However, circumcision should be considered in boys with a high risk of recurrent febrile infection, that is boys with previous UTIs and/or high-grade VUR, where the number needed to treat is between 4 and 11, so that the benefits outweigh the risk of adverse effects.

[madbr3991]

i see they lumped male and female children together . thats odd because females are much more likely to get a UTI then any male due to body structure. the only reason to do this would be to up the percent of UTI in the paper. and then try to use that inflated number to push circumcision. data manipulation