Recurrent UTI

A 7 year old female was brought by her mother to the OPD with complaints of increased frequency of urination. She also says that she has had multiple episodes of UTI in the past too. Upon Urine RM, Pus cells are full field. Advised to undergo USG KUB, URINE CS What would be the best line of management for this patient? Can cefalexin be advised for recurrent UTI or else?

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SUGGESTIVE OF RECURRENT U. T. I.... ADVISABLE... U. S. G........ ABDOMEN. AND. KUB. REGION URINE....C / S..
Diagnosis : recurrent UTI Look for Any stricture urethra Chronic cystitis Hypo or epispasdias Renal cyst or pyelonephritis AGN , renal stone Adv: usg KUB , urine C/S T/t start tab uritop 100 bd Citralka syrup tds Give antibiotic for 15. - 20 days Follow by urine routine Patient require IV antibiotics Start piptaz bd Inj amikacin bd
Cefuroxime axetiil ( Ceftum ) 250 mg BD can be started empirically while waiting for CS report . Structural abnormalities like refluxing megaureters can cause recurrent UTI in this age group . DM1 may be ruled out .
Wait for usg nd CS Then decide plan of treatment. Still alkalizer wth symptomatic treatment.
Ask for URINE C/S then treat accordingly and adv him use Jet to wash after defecation
Go for urine culture sensitivity then decide for antibiotic USG of pelvis
Recurring UTI Ad urine for C/S NFT is drug of choice
For chr uti best choice is nitrofuradentine
Thanx dr Pushkar ji Bhomia
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A case of recurrent UTI is difficult to treat as patient requires prolonged antibiotics which they generally do not take But best option is Prescribing Antibiotics after culture and sensitivity. Nitrofurantoin 100 mg B.D is the drug which is least resistant and also inj Amikacin .These 2 can be used .For prolonged use NFT is better . Addition of alkaliser and cranberry extract + D mannose tablets for 2 months will prevent recurrence
In a female child with recurrent UTI.. always..rule out possibility of enterobial infestation.. E. vermiculris or pinworms often cause vaginits.. urethritis.. syndrome. A course of deworming..and stringent personal hygiene...may be helpful.
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