Urinary Tract Infections in Children - Treatment Overview

Treatment Overview

Antibiotic medicine and home care are effective in treating most urinary tract infections (UTIs) in infants and children. The main goal of treatment is to prevent kidney damage and its short- and long-term complications by eliminating the infection quickly and completely. Early evaluation and treatment are very important. Do not delay calling a doctor if you think your baby or young child may have a UTI.

Home treatment includes:

• Having your child drink extra fluids to flush bacteria out of the bladder.
• Reminding your child to urinate often and to empty the bladder each time.

Initial treatment

Infants and young children with urinary tract infections (UTIs) need early treatment to prevent kidney damage. Your doctor is likely to base the initial treatment decision on your child's symptoms and urinalysis results rather than waiting for the results of a urine culture.

Treatment for most children with UTIs is oral antibiotics and home care. If your child is younger than 3 months of age, is too nauseated or sick to take oral medicines, or has an impaired immune system, brief hospitalization and a short (1- to 3-day) course of intravenous (IV) antibiotics may be necessary. After your child's fever and other symptoms improve and he or she is feeling better, the doctor may prescribe oral medicines for another 7 to 10 days. The overall length of treatment varies, depending on the severity and location (bladder or kidneys) of infection, your child's age and medical history, and other factors.

Infants and young children being treated for their first UTI need follow-up evaluation after the infection is gone. Tests may include an ultrasound of the kidneys and a voiding cystourethrogram to identify vesicoureteral reflux and other structural or functional problems with the urinary tract that could increase the child's risk for repeat infections and kidney damage. The doctor may do periodic urine cultures during the first year after a child's first UTI to screen for repeat infection.

Treatment if the condition gets worse or recurs

If your child's urinary tract infection (UTI) does not improve after treatment with antibiotics, he or she needs further evaluation and may need additional antibiotic treatment. Your child may have a structural problem that is making the infection difficult to treat, or the cause of the infection may be different from the types of bacteria that usually cause UTIs.

If the infection spreads and affects kidney function or causes widespread infection (sepsis), your child may be hospitalized. These complications are rare, but they can be very serious. Children with impaired immune systems, untreated urinary tract obstructions, and other conditions that affect the kidneys or bladder are at higher risk for complications.

Recurrent UTIs increase the risk of long-term kidney damage and high blood pressure. The doctor may prescribe preventive antibiotic therapy after treatment for a first UTI if your child has a structural problem, such as vesicoureteral reflux, that increases the risk of additional infections, or if your child has more than two UTIs in a 6-month period.