Is this Standard Treatment for a UTI?

[ZoeyZoo]

****Cross posted in Health and Healing***

I have a 22 month DD. She was in pain peeing and had a strong smell to her urine so we brought her to the dr for abx suspecting UTI. We decided not to go the natural route because we was in pain and dislikes cranberries. This is her first UTI.

The dr took a urine sample and perscribed abx. It was also cultered it and it is an E-Coli UTI.

The question I had is what would be standard treatment for a first time case? She is on a 10 day course of ABX. They want further testing including another sample and an ultrasound afterward. That's all the dr would go into detail over the testing. The sample along was very tramatic for DD so we want to avoid this if it's unnecessary.

This seems excessive to both me and DH since this is not recurrent and she has no signs of kidney infection. What is normal for a toddler?

[moonjunio]

I am no fan of antibiotics but from her symptoms it seems like a 10 day course is not a bad idea for a UTI.

As far as testing goes, I will speak from a bad experience I had - if you don't get the pee sample with a catheter and go with the "bag" method instead, make SURE that the nurse sterilizes her genitals with disinfectant first! I once took my infant daughter to urgent care with a fever and nothing else, the nurse put a bag on her without cleaning first. The culture grew out (of COURSE) so I was told I had to start antibiotics. But at her follow up appt with an actual pediatrician I saw the nurse swab her down, I put 2+2 together and now I'm sure she never had a UTI in the first place. (Side bar: she wouldn't pee in the bag and had to get a catheter instead, the pee was perfect even though I had stopped the antibiotics due to a suspected reaction).

[Latte Mama]

If she has E Coli in her urine then yes, I would want abx. Even though I am a nurse, I am not a fan of abx due to superbugs and resistance. However, UTI's can travel to the kidneys and you don't want to take that chance. Even though it's just in her urethra now, untreated, it could potentially get much worse. Plus, UTI's are very painful! I wouldn't NOT treat my own Ecoli UTI. JMO.

[ZoeyZoo]

Thank you for the comments so far. Yes, we started the abx. My question was more about the testing afterward. It seems excessive to me for a first UTI to do additional cultures, ultrasound, etc.

[serenbat]

ultrasound - did you ask what they hope to gain from one? since when is this standard?

[springmum]

after DS (also 22 months) had his first UTI several weeks ago, the dr also ordered a renal ultrasound.

We don't need another urine sample, although his was not traumatic b/c he used to peeing in the potty (not fully trained though) so asking him to pee in the cup was funny for him.

The reason the dr gave us, is that it is standard for her office, especially in boys, since it is not very common. They want to check to make sure everything is in the right place and flowing as it should.

I had asked in H&H at the time about others' experiences with renal ultrasounds with children, and I gathered they were fairly non-invasive, quick and relatively easy as far as ultrasounds go.

We are going ahead with the ultrasound b/c it would be nice to rule out any body disfunction that contributed to his UTI.

In the meantime I give him some D.Mannose every day, it dissolves easily in water (he won't drink a drop of juice) it helps keep the urine clear.

We did originally try the natural route and it did not work, so we also did the abx, and I'm glad we did (also remembered to up the probiotics too)

Our ultrasound is booked for mid-april, so we'll see how it goes.

That's our experience Hope she is feeling better quickly!

[workjw]

Yes, it is standard testing to do another urine culture after a 10 day course of abx for UTI. UTI's are nasty little boogers, and they sometimes tend to hang around. They do another culture to make sure that the infection has cleared completely. Since you won't be deciding treatment based on the sample, you might be able to "catch" a sample at home in a sterile cup and take it in. We did this sometimes in the bathtub with nakey play time. If it comes back positive you will definitely want to cath again in case it was contaminated.

It is also pretty standard to do an ultrasound, even after the first infection, especially before a child is potty trained. Some doctors actually suggest a VCUG (which is MUCH more invasive) after just 1 infection. The reason that they do the u/s is to be sure that there are not any urinary or renal abnormalities. The concern is that a child with a UTI might have a condition called kidney reflux (vesicoureteral reflux). About 1/3 of kids that present with UTI have this condition which is why they are so aggressive about it. Most of them have low grades of the condition, and of that 1/3, 80% will outgrow the condition. But, it can be very serious if not treated or if the grade is high. They are just looking to make sure that there are no obvious abnormalities that might point to a problem. You can't know for sure about kidney reflux without the VCUG, but an u/s will show most major problems (like swelling in the kidneys, ureters and renal scarring).

I might not be as concerned with no signs of kidney infection and no recurring urinary issues, but I would want to know for sure. Kidney reflux is definitely not something you want to overlook. An u/s is not very invasive, and well worth it in my opinion.

Hope your lo is feeling better soon!

eta: good luck on the u/s springmum!

[Thalia]

I had persistent UTI's as a child, and eventually had to have a VCUG at around 8 years old. It was traumatic for me, although the doctors and nurses were very nice. I would SO much rather have had an ultrasound! They were able to rule out any major problems, and eventually I outgrew the UTI's.