Treatment for Urinary Tract Infection of Children in Korea

Kang, Hee-Gyung; Kim, Kwang-Myung; Cheong, Hae-Il; Choi, Hwang; Choi, Yong

J Korean Soc Pediatr Nephrol > Volume 5(1); 2001 > Article

J Korean Soc Pediatr Nephrol 2001;5(1): 15-21.

우리나라 어린이 요로 감염의 치료 행태

강희경, 김광명, 정해일, 최황, 최용

¹서울대학교 의과대학 소아과학 교실
²서울대학교 의과대학 소아과학 교실
³서울대학교 의과대학 소아과학 교실
⁴서울대학교 의과대학 소아비뇨기과학교실
⁵서울대학교 의과대학 소아과학교실

Treatment for Urinary Tract Infection of Children in Korea

Hee-Gyung Kang, Kwang-Myung Kim, Hae-Il (NULL) Cheong, Hwang Choi, Yong Choi

¹Department of Pediatrics, Seoul National University, College of Medicine
²Department of Pediatrics, Seoul National University, College of Medicine
³Department of Pediatrics, Seoul National University, College of Medicine
⁴Department of Pediatric Urology, Seoul National University, College of Medicine
⁵Department of Pediatrics, Seoul National University, College of Medicine

ABSTRACT

PURPOSE : Urinary tract infections (UTIs) of children require prompt and correct diagnosis and treatment to reduce the risk of renal damage. As a first step to improve the outcome of UTI in Korea, we investigated the practical variations in the methods of diagnosis, treatment, and evaluation of children with UTI and UTI prevention. METHOD : A questionnaire related to the individual policy on UTI diagnosis, treatment, imaging test, and prevention was submitted to 26 experts. RESULT : Majority of the experts used bag-collected urine specimen for infants and mid-stream urine specimen for children for urinary culture. With a negative result of culture study, they diagnosed UTI when there was pyuria, positive results of the nitrite test, or bacteriuria. 80 % of experts prescribed prophylactic antibiotics after upper tract UTI. Operative treatment of vesicoureteral reflux (VUR) was indicated for children older than one or two years old with high-grade VUR, refractory breakthrough infections, or recurrent UTIs. Most of them performed kidney ultrasonography on the diagnosis of UTI and more than half of them evaluated children treated of UTI with vesicocystourethrogram and/or DMSA scintigraphy. Majority did not recommend circumcision. Half of the experts were screening siblings of VUR patients. CONCLUSION : Considering the variations exposed through this study, systematic guidelines for management of children with UTI in Korea would be necessary.

Key words: diagnosis | treatment | evaluation | prevention | vesicoureteral reflux