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Journal of the Korean Society of Pediatric Nephrology 2012;16(2): 95-101. doi: https://doi.org/10.3339/jkspn.2012.16.2.95
대구지역 소아청소년과 의사들의 요로감염 관리 실태분석
이상수, 강석정, 이재민, 조민현, 박용훈
1영남대학교 의과대학 소아청소년과
2순천향대학교 의과대학 구미병원 소아청소년과
3영남대학교 의과대학 소아청소년과
4경북대학교 의과대학 소아청소년과
5영남대학교 의과대학 소아청소년과
Management of Urinary Tract Infections in Children: A Survey of Pediatricians in Daegu City
Sang Su Lee, Seok Jeong Kang, Jae Min Lee, Min Hyun Cho, Yong Hoon Park
1Department of Pediatrics, Yeungnam University College of Medicine
2Department of Pediatrics, Soon Chun Hyang University Gumi Hospita
3Department of Pediatrics, Yeungnam University College of Medicine
4Department of Pediatrics, Kyungpook National University School of Medicine
5Department of Pediatrics, Yeungnam University College of Medicine
Received: September 15, 2012;  Revised: September 25, 2012.  Accepted: October 8, 2012.
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ABSTRACT
Purpose: Recently, many evidence-based guidelines for the management of urinary tract infection (UTI) have been developed because of the importance of proper management. However, there is a lack of data regarding how pediatricians manage UTIs in Korea. Therefore, we surveyed pediatricians to determine whether they manage UTIs in an appropriate manner.
Methods: A postal questionnaire survey of 78 pediatricians practicing in Daegu city was performed. Subjects were asked about diagnosis, imaging studies, treatment, and prevention of UTIs.
Results : Most of the respondents (94.8%) performed urinalysis to diagnose UTI in febrile children with an unknown fever focus. However, many preferred inaccurate collection methods, such as bagged urine collection, and did not obtain urine cultures. The most frequently performed imaging modality was renal-bladder ultrasonogram. Orally administered antibiotics were preferred unless admission was needed. After diagnosis of UTI, the pediatricians usually provided information to caregivers about the disease itself and supplementary treatment. Of the respondents, only 28.6% had their own guidelines for management of vesicoureteral reflux.
Conclusion : Most pediatricians suspected UTI in febrile children with an unknown focus appropriately. Nevertheless, the fact that many pediatricians preferred inaccurate urine collection methods and did not perform sufficient imaging studies to detect associated abnormalities likely resulted in overtreatment due to false-positive diagnosis of UTI and a low probability of ruling out genitourinary anatomical problems. To improve the quality of management of UTI, pediatricians should follow scientific and evidence-based guidelines.
Key words: Urinary tract infections | Pediatrics | Guideline | Primary health care | Data collection
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