Navigation Links
IU analysis changing diagnosis and management of initial UTIs in young children

INDIANAPOLIS Analysis by Indiana University School of Medicine researchers of ten years of scientific studies has resulted in changes in American Academy of Pediatrics recommendations for how initial urinary tract infection in infants and toddlers is diagnosed and treated. This change will affect thousands of children every year.

The findings of the IU School of Medicine investigators argue against exposing all young children who are diagnosed with an initial urinary tract infection (UTI) to a painful radiologic test and against prescribing prophylactic antibiotic treatment that may extend for years -- the diagnosis and management tools indicated in the American Academy of Pediatrics' current guideline, established in 1999. The new study was conducted at the request of the AAP.

As a result of these findings, the AAP has updated its practice guideline on the diagnosis and management of initial UTIs in children aged two to 24 months. The report and the new AAP guideline appear in the September issue of the journal Pediatrics.

UTIs are one of the most common bacterial infections in babies and toddlers. Five percent of children in this age group with fever and no other obvious fever source have UTI. Diagnosis and management are clinically challenging because the patients are unable to express their symptoms. Repeated UTIs can lead to kidney scarring and life-long decreased kidney function.

In the 1999 guideline a radiologic test called a voiding cystourethrogram (VCUG) was recommended for young children after a first UTI. This was done to identify children with urine refluxing back up to the kidney. When identified, most of these children were started on prophylactic antibiotics in an attempt to prevent repeated episodes of UTI. But when the IU researchers reviewed studies done in the decade following the old 1999 guidelines, they found no benefit to long-term prophylactic antibiotics. Given that antibiotics do not work, they determined there was no reason to put all these children through the pain and radiation of the VCUG.

"If there is no obvious source of fever, the pediatrician needs to think UTI and needs to test for it. But we need to now change what we do after we have treated that first episode of UTI. We, as physicians, have been fooling ourselves by putting young patients on long-term antibiotics and thinking that would prevent the patient from getting another UTI," said S. Maria Finnell, M.D., assistant professor of pediatrics at the IU School of Medicine, lead author of the technical report and an author of the AAP policy statement.

"Technical ReportDiagnosis and Management of an Initial UTI in Febrile Infants and Young Children" accompanies the AAP's new clinical practice guidelines "Clinical Practice GuidelineDiagnosis and Management of Initial UTIs in Febrile Infants and Children Aged 2 to 24 Months."

"The AAP is the authoritative source of pediatric guidelines in the United States and beyond. This change in recommendations will have a substantial impact on clinical practice," said Stephen M. Downs, M.D., professor of pediatrics at the IU School of Medicine and co-author of the new technical report. Dr. Downs was the author of a 1999 technical report that informed the earlier AAP guideline.


Contact: Cindy Fox Aisen
Indiana University School of Medicine

Related medicine news :

1. UBC researchers create more powerful lab-on-a-chip for genetic analysis
2. Localized reactive badger culling raises bovine tuberculosis risk, new analysis confirms
3. Novel analysis method organizes genomic cancer data
4. The Cancer Genome Atlas completes detailed ovarian cancer analysis
5. In a new post-hoc analysis, significantly more patients achieved blood sugar goals with JANUMET
6. Analysis finds mortality from all causes higher among hepatitis C-infected
7. Drug Marketing Often Targets Med Students: Analysis
8. Climate change analysis predicts increased fatalities from heat waves
9. Screening for hepatitis B may be cost-effective for more of the population, analysis shows
10. UCSF analysis shows newer surgery for neck pain may be better
11. Analysis of opioid prescription practices finds areas of concern
Post Your Comments:
Related Image:
IU analysis changing diagnosis and management of initial UTIs in young children
(Date:11/25/2015)... ... November 25, 2015 , ... ... Complex (TSC), as well as raising public awareness of the disorder while helping ... a third donation of $35,000 to bolster progress at the Tuberous Sclerosis Complex ...
(Date:11/25/2015)... ... ... Students and parents have something to be thankful for this Thanksgiving week ... California Casualty is proud to support the contest designed to utilize peer-to-peer ... the number one killer of young drivers. , Almost 1,000 entries of original ...
(Date:11/24/2015)... ... November 25, 2015 , ... ... Their Care Plan software creates an agreement between the practice owner and ... including financial, scheduling, monitoring, notification, and projections. Click here to ...
(Date:11/24/2015)... ... ... Dr. Todd S. Afferica, a noted general dentist in Norcross, GA , ... now uses the BIOLASE WaterLase iPlus 2.0™ in many of his dental procedures. This ... cutting tools, such as the scalpel and high-speed drill, which can both cause patients ...
(Date:11/24/2015)... ... ... Young patients with a wide variety of dental needs can now receive ... who are pediatric dentists in Tucson, AZ . Unlike traditional treatment options that ... minimal discomfort and bleeding to the patient during treatment and the following recovery period. ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... HILL, N.C. , Nov. 24, 2015  In ... research projects in an effort to quickly uncover new ... position. --> --> ... launch a market research project and ensure that all ... company and industry standards. Another major barrier to efficiently ...
(Date:11/24/2015)... Nueva York , 24 de noviembre ... fabricante del Avery Breathing Pacemaker System, se complace ... MD; Ph.D. como consultor clínico. ... --> Foto -   ... doctor Jonzon es un fisiólogo y consultor en ...
(Date:11/24/2015)... Nov. 24, 2015  DILON Diagnostics and GE Healthcare ... agreement for DILON to distribute GE,s Discovery NM750b Molecular ... signing of this distribution agreement will provide Dilon,s experienced ... Imaging system and is considered an initial step in ... solutions for clinicians and their patients. ...
Breaking Medicine Technology: