Update on Associated Risk Factors, Diagnosis, and Management of Recurrent Urinary Tract Infections in Children

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Abstract

Recurrent urinary tract infection (rUTI) continues to challenge pediatric care providers. The diagnosis of an rUTI can be difficult, especially in young febrile children. Antibiotic resistance rates continue to rise, which limits oral treatment options. Prophylactic antibiotics are used commonly to manage rUTI, but their use increases the risk of rUTI with antibiotic-resistant strains without significantly reducing renal scarring. Alternative therapies for rUTI include probiotics and anthocyanidins (eg, cranberry extract) to reduce gut colonization by uropathogens and prevent bacterial adhesion to uroepithelia, but efficacy data for these treatments are sparse. The future of rUTI care rests in addressing the following contemporary issues: best diagnostic practices, risk factors associated with rUTI, and the prevention of recurrent infection. In this review, we summarize the state of the art for each of these issues and highlight future studies that will aim to take an alternative approach to managing rUTI.

Original languageEnglish (US)
Pages (from-to)152-159
Number of pages8
JournalJournal of the Pediatric Infectious Diseases Society
Volume8
Issue number2
Early online dateJul 23 2018
DOIs
StatePublished - May 11 2019

Fingerprint

Risk Management
Urinary Tract Infections
Vaccinium macrocarpon
Bacterial Adhesion
Anti-Bacterial Agents
Anthocyanins
Probiotics
Complementary Therapies
Microbial Drug Resistance
Practice Guidelines
Cicatrix
Fever
Pediatrics
Kidney
Infection

Keywords

  • antibiotic resistance
  • diagnosis
  • probiotics
  • recurrent UTI

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases

Cite this

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title = "Update on Associated Risk Factors, Diagnosis, and Management of Recurrent Urinary Tract Infections in Children",
abstract = "Recurrent urinary tract infection (rUTI) continues to challenge pediatric care providers. The diagnosis of an rUTI can be difficult, especially in young febrile children. Antibiotic resistance rates continue to rise, which limits oral treatment options. Prophylactic antibiotics are used commonly to manage rUTI, but their use increases the risk of rUTI with antibiotic-resistant strains without significantly reducing renal scarring. Alternative therapies for rUTI include probiotics and anthocyanidins (eg, cranberry extract) to reduce gut colonization by uropathogens and prevent bacterial adhesion to uroepithelia, but efficacy data for these treatments are sparse. The future of rUTI care rests in addressing the following contemporary issues: best diagnostic practices, risk factors associated with rUTI, and the prevention of recurrent infection. In this review, we summarize the state of the art for each of these issues and highlight future studies that will aim to take an alternative approach to managing rUTI.",
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