BREAKING NEWS ON URINARY TRACT INFECTIONS

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BREAKING NEWS ON URINARY TRACT INFECTIONS (UTI)

On July 1, the official journal of the American Academy of Pediatrics just published an important study on

urinary tract infections.

Many of you may not realize it, but there are actually two reasons we like to diagnose and treat urinary tract infections

(UTI's):

1. To help your child feel better. Curing the illness ends the symptoms
2. Prevent kidney damage. Some UTI's spread to the kidney and cause scarring.

For many, many years, the teaching has been that UTI's are more likely to spread to the kidney if you are an infant

and if you have reflux.

Reflux is a condition in the urinary system in which urine goes up to the kidney as well as out into the toilet when you

urinate. Reflux is a physical property of your urinary system and is not caused by infection. You either have it

or you do not. With time those with reflux tends to stop having reflux as they get older.

The New Findings

Now comes a very important study of many hundreds of children with first time UTI's, from age 1 month to age 14 years.

Everyone with such a UTI had fever measured, some blood tests, and two radiology studies that proved if the

person had reflux and if the person had actual kidney infection with their UTI. Six months later they repeated a study

to see if any scars developed in the kidney.

This is the first time anyone has actually directly measured whether a child's UTI caused kidney infection and later kidney scarring

What they found was that the our prior understandings were quite wrong.

If you have a UTI, you are much more likely to have kidney infection as you get older, infants are actually less likely to

have kidney infection when they have a UTI.

Further, there appears to be no connection between reflux and getting a kidney infection or later kidney scarring from

an infection.

How This Changes How UTI's Should be Managed

Prior to this study, the question of whether you had reflux to your kidneys seemed critically important to protecting the

kidneys in future UTI's. This no longer appears to be the case.

Prior to this study, it was clear that doing a study to find out if you have reflux, now this intervention seems no longer

important to do.

At this time, the state-of-the-art approach to managing UTI's will be to:

1. Obtain a urine sample to see if there is an infection
2. Only if there is a bacterial infection, treat with antibiotics
3. Make sure you get better.

This appears the best way to make your child feel better and to protect the kidneys.

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