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FP EBM Journal Club

Introduction. American Academy of Pediatrics Practice GuidelineThe Diagnosis, Treatment, and Evaluation of the Initial Urinary Tract Infection in Febrile Infants and Young Children" 1999 Recommendation 11Infants and young children, 2 mo to 2 yr, with UTI, who do not demonstrate the expected cl

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FP EBM Journal Club

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    1. FP EBM Journal Club Imaging Studies After First Febrile Urinary Tract Infection in Young Children [NEJM 2003; 348: 195-202] Ellen Chen, M.D. February 5, 2003

    2. Introduction American Academy of Pediatrics Practice Guideline The Diagnosis, Treatment, and Evaluation of the Initial Urinary Tract Infection in Febrile Infants and Young Children 1999 Recommendation 11 Infants and young children, 2 mo to 2 yr, with UTI, who do not demonstrate the expected clinical response within 2 days of antimicriobial therapy, should undergo ultrasonography promptly. Voiding cystourethrography (VCUG) or radionuclide cystography (RNC) is strongly encouraged to be performed at the earliest convenient time. Infants and young children who have the expected response to antimicrobials should have a sonogram, performed at the earliest convenient time; a VCUG or RNC is strongly encouraged.

    3. (Strength of evidence: fair) The article under discussion examines these recommendations, offering no definitive answers but raising interesting questions.

    4. Epidemiology of UTIs by sex UTIs occur in 1.5 to 5 times as many males as females in the neonatal period Prevalence in febrile girls < 1yr is 6.5% vs 3.3% in boys Prevalence in febrile girls between 1 to 2 yr is 8.1% vs 1.9% in boys

    5. After pediatric febrile UTIs: why all the concern? Recurrent UTIs increase the risk of renal damage in children. There may be a delay in diagnosis and treatment of UTIs in infants and young children. Difficulty of diagnosis Social factors

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