Allie is a 5 year old who presents with frequency and burning upon urination. This started 1 day ago. No fever, and she wet the bed last PM. No prior history of UTI. Vomited x1 yesterday. Her weight is 46 pounds (46lbs= 20, 9 kg= 21 kg).
Exam. Unremarkable. Some regionalized abdominal pain. No suprapubic tenderness. Urine dip in office reveals 2+ bacteria, +nitrites, neg blood, glucose, ketones. Perineal area slightly excoriated.
What would your treatment plan be for this patient? What would you prescribe?
Allie presents with symptoms of urinary tract infection. Her urinalysis was positive for leukocytes and nitrates. Physical assessment revealed frequency and burning upon urination, nocturnal incontinence, vomited x 1, some …show more content…
Rationale: urine culture is crucial to confirm the diagnosis of UTI (Burns et. al., 2013, p. 815).
• Start antibiotic Cefixime (Suprax) 8mg/kg/day PO divided q12h x 4 days or until culture and sensitivity available. DO not exceed 400mg/day (“Suprax”, 2016).
• Give Ibuprofen 10mg/kg q6h PRN for pain/fever, max 40mg/kg/day (“Ibuprofen”, 2016). …show more content…
This guideline targets children from 1 month to 18 years old with suspected urinary tract infection. Acute phase of UTI requires: initiation of early empirical treatment; empirical therapy administration route (intravenous, oral); choice of empirical antibiotic therapy; and duration of antibiotic treatment. For a child, who can control urination the urine specimen should be obtained via midstream clean catch. Urine dipstick test and macroscopic examination of urine should be conducted to help with diagnosis of UTI. Allie presented with symptoms of UTI (frequency, burning on urination, nocturnal incontinence, regionalized abdominal pain). “In patients older than 2 years with high suspicion of UTI (specific symptoms with presence of nitrates or bacteriuria, with or without leucocytes), it’s recommended to start empirical antibiotic treatment after collecting urine culture” (“Clinical practice”, 2013). Cystography (voiding cystourethrogram VCUG) is not recommended after first UTI, unless there is a recurrent UTI, abnormalities in previous ultrasound or DMSA, signs of lower urinary dysfunction, or family history of vesicoureteral reflux (“Clinical practice”, 2013). For empirical antibiotic treatment of UTI without fever the following antibiotics should be used: amoxicillin-clavulanate, 1st
Exam. Unremarkable. Some regionalized abdominal pain. No suprapubic tenderness. Urine dip in office reveals 2+ bacteria, +nitrites, neg blood, glucose, ketones. Perineal area slightly excoriated.
What would your treatment plan be for this patient? What would you prescribe?
Allie presents with symptoms of urinary tract infection. Her urinalysis was positive for leukocytes and nitrates. Physical assessment revealed frequency and burning upon urination, nocturnal incontinence, vomited x 1, some …show more content…
Rationale: urine culture is crucial to confirm the diagnosis of UTI (Burns et. al., 2013, p. 815).
• Start antibiotic Cefixime (Suprax) 8mg/kg/day PO divided q12h x 4 days or until culture and sensitivity available. DO not exceed 400mg/day (“Suprax”, 2016).
• Give Ibuprofen 10mg/kg q6h PRN for pain/fever, max 40mg/kg/day (“Ibuprofen”, 2016). …show more content…
This guideline targets children from 1 month to 18 years old with suspected urinary tract infection. Acute phase of UTI requires: initiation of early empirical treatment; empirical therapy administration route (intravenous, oral); choice of empirical antibiotic therapy; and duration of antibiotic treatment. For a child, who can control urination the urine specimen should be obtained via midstream clean catch. Urine dipstick test and macroscopic examination of urine should be conducted to help with diagnosis of UTI. Allie presented with symptoms of UTI (frequency, burning on urination, nocturnal incontinence, regionalized abdominal pain). “In patients older than 2 years with high suspicion of UTI (specific symptoms with presence of nitrates or bacteriuria, with or without leucocytes), it’s recommended to start empirical antibiotic treatment after collecting urine culture” (“Clinical practice”, 2013). Cystography (voiding cystourethrogram VCUG) is not recommended after first UTI, unless there is a recurrent UTI, abnormalities in previous ultrasound or DMSA, signs of lower urinary dysfunction, or family history of vesicoureteral reflux (“Clinical practice”, 2013). For empirical antibiotic treatment of UTI without fever the following antibiotics should be used: amoxicillin-clavulanate, 1st