Repeated Episodes of UTI - Pediatric Oncall

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Question
This is a query regarding my 7 1/2 month old son. 27/09/01 Sudden fever with rigors - 2 episodes of rigors was diagnosed as Urinary tract infection Culture >100000 colonies of E coli. Treated with Ceftum 5ml bd x 10 days Inj Amikacin IM X 6 days. Urine culture at the end of the course was negative. He had fever 10 days back for 3 days which was treated with Ibugesic Plus. On the third day we gave urine for culture. After giving the sample he was asymptomatic with no fever. No antipyretic/antibiotic was given for next 2 days. Provisional culture report after 2 days showed 50,000 colonies of E coli. A repeat sample was given for culture at this time. The provisional report of this on the next day showed 10,000 colonies. The colonies reduced from 50000 to 10000 without any treatment. Anyways he has been put on Ceftum for 10 days (which he hates) and has been advised a 2 month prophylaxis with __-___Norflox DT 100mg x od x 2 months. A protocol of multiple periodic urine cultures for next 2 years has been advised. Confusing issues are is the second infection significant? Is such an extensive management necessary? Is MCU required? Is Norflox the right drug for Prophylaxis? Kindly advice at the earliest as he completes his 10 days of Ceftum on 8th November.
Answer
This is what our expert has to say: Since, your son has had a UTI (maybe repeated episodes) extensive investigations would be required. A minimum of MCU and USG of the kidneys would be required in addition to the urine culture. Since, he is a male child, underlying kidney disease should be ruled out. Depending upon the investigations, further prophylaxis can be decided. Norflox is a very good antibiotic, however, it is not recommended for long term prophylaxis. For prophylaxis cotimaxazole and nitrofurantoin are good agents. However, they are to be taken under your doctor's guidance. Back to All Questions

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